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Organization
PREMISE HEALTH OF OHIO MEDICAL, P.A
Active
Organization
PREMISE HEALTH OF OHIO MEDICAL, P.A
Active
Other names
Harley Davidson Health Center-Kansas City
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN M.D (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
11401 N CONGRESS AVE, KANSAS CITY, MO 64153-1473
(816) 270-8444
(816) 270-8633
Mailing address
16906 COLLECTION CENTER DR, CHICAGO, IL 60693-0169
(816) 270-8444
(816) 270-8633
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2011
Last updated
08/16/2022
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