Healthcare Provider Details

I. General information

NPI: 1407899131
Provider Name (Legal Business Name): FAMILY CARE AT ARBOR WALK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SW ARBOR WALK BLVD SUITE A
LEE'S SUMMIT MO
64082
US

IV. Provider business mailing address

1301 SW ARBOR WALK BLVD SUITE A
LEE'S SUMMIT MO
64086
US

V. Phone/Fax

Practice location:
  • Phone: 816-534-6232
  • Fax:
Mailing address:
  • Phone: 816-534-6232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICK KUENY
Title or Position: VP
Credential:
Phone: 816-537-6232