Organization
WANLESS EAR, NOSE & THROAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK M. WANLESS MD (PHYSICIAN OWNER)
(660) 263-4600
Entity
Organization
Contact information
Practice address
1513 UNION AVE STE 1200, MOBERLY, MO 65270-9405
(660) 263-4600
(660) 263-4640
Mailing address
1513 UNION AVE STE 1200, MOBERLY, MO 65270-9405
(660) 263-4600
(660) 263-4640
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
MO
Other
Enumeration date
02/23/2006
Last updated
03/03/2020
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