Individual
CHARLES EDWARD MAHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
901 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64086-5544
(816) 581-5899
(816) 347-3046
Mailing address
1103 GRAND BLVD, KANSAS CITY, MO 64106-2404
(913) 424-0860
(816) 347-3046
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2016017975
MO
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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