Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Feb 8, 2019
License(s)
2019004017 (MO)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 901 MCCLINTOCK DR STE 202 | Burr Ridge, IL 60527-0872 | 630-655-8320 |
| LOCATION | 2340 E MEYER BLVD, BLDG 2 SUITE 392 | Kansas City, MO 64132-0001 | 816-444-7977 |
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