Healthcare Provider Details

I. General information

NPI: 1053474106
Provider Name (Legal Business Name): MEN'S HEALTHLINK OF KANSAS CITY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 NE RALPH POWELL RD SUITE C
LEES SUMMIT MO
64064-2357
US

IV. Provider business mailing address

3600 NE RALPH POWELL RD SUITE C
LEES SUMMIT MO
64064-2357
US

V. Phone/Fax

Practice location:
  • Phone: 816-875-1105
  • Fax: 816-875-1103
Mailing address:
  • Phone: 816-875-1105
  • Fax: 816-875-1103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD HOFFINE
Title or Position: DIRECTOR
Credential:
Phone: 816-283-2305