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General NPI Number Information
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NPI Number | 1760476063
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Entity Type | Organization
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Legal Business Name | WOMENS CLINIC ASSOCIATES PA
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 3550 S 4TH ST STE 150
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5071
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Country | US
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Telephone | 913-788-9797
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Fax | 913-788-5263
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Provider Business Mailing Address
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Address Line | 3550 S 4TH ST STE 150
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5071
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Country | US
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Telephone | 913-788-9797
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Fax | 913-788-5263
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISA A LORENZETTI
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Credential | MD
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Telephone | 913-788-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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