MEDICARE: HEALTHY LIVING FIRST MEDICAL GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1720418874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY LIVING FIRST MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	1202 N 38TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-2229
Country	:	US
Telephone Number	:	913-777-7600
Fax Number	:	913-777-7619

Provider Business Practice Location Address
First Line	:	1202 N 38TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-2229
Country	:	US
Telephone Number	:	913-777-7600
Fax Number	:	913-777-7619

Authorized Official
Title or Position	:	PHYSICIAN, OWNER
Name	:	ALANNA HUNTER LEE
Credential	:	MD
Telephone Number	:	913-777-7600

Provider Enumeration Date	:	11/26/2013
Last Update Date	:	06/05/2014

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