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General NPI Number Information
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NPI Number | 1255991238
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Entity Type | Organization
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Legal Business Name | LEE SUMMIT ASC KC LLC
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 2861 NE INDEPENDENCE AVE STE 101
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City | LEES SUMMIT
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State | MO
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Zip | 64064-2379
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Country | US
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Telephone | 816-579-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 2861 NE INDEPENDENCE AVE STE 101
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City | LEES SUMMIT
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State | MO
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Zip | 64064-2379
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Country | US
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Telephone | 816-579-1500
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JUSTIN TURENTINE
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Credential |
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Telephone | 816-579-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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