Individual
CHELSEA FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11725 W 112TH ST, OVERLAND PARK, KS 66210-2761
(913) 787-4008
Mailing address
11725 W 112TH ST, OVERLAND PARK, KS 66210-2761
(913) 469-5579
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2021022625
MO
207Q00000X
Family Medicine Physician
Primary
9409365
KS
Other
Enumeration date
03/30/2017
Last updated
10/26/2022
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