Individual
MR. JEFFERY KEITH MINCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 CAISSON HILL ROAD, CTMC, FORT RILEY, KS 66442
(785) 239-4411
Mailing address
1703 7TH ST, CLAY CENTER, KS 67432-1803
(785) 447-0369
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1098
KS
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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