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General NPI Number Information
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NPI Number | 1497531537
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Entity Type | Organization
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Legal Business Name | ARCHWAY CLINICS LLC
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 7180 W 107TH ST STE 11
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2523
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Country | US
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Telephone | 224-337-8925
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Fax | 816-912-1739
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Provider Business Mailing Address
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Address Line | 7180 W 107TH ST STE 11
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2523
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Country | US
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Telephone | 224-337-8925
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARCUS G MELESIO
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Credential | OWNER
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Telephone | 224-337-8925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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