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General NPI Number Information
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NPI Number | 1730547167
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE CONCUSSION CARE, P.A.
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Dates
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Enumeration Date | 01/30/2016
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Last Update Date | 01/30/2016
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Provider Practice Location Address
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Address Line | 11940 W 119TH ST
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City | OVERLAND PARK
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State | KS
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Zip | 66213-2216
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Country | US
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Telephone | 913-907-9554
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Fax |
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Provider Business Mailing Address
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Address Line | 27850 SILVER WRAITH DR
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City | OLATHE
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State | KS
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Zip | 66061-8912
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | PREM PARMAR
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Credential | MD
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Telephone | 913-351-3005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 04-28802
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License Number State | KS
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