Organization
CENTER FOR CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LAKIN D.O. (MEDICAL DIRECTOR/AUTHORIZED OFFCIAL)
(316) 640-0601
Entity
Organization
Contact information
Practice address
933 N TOPEKA ST, WICHITA, KS 67214-3620
(316) 201-1234
(316) 201-1673
Mailing address
933 N TOPEKA ST, WICHITA, KS 67214-3620
(316) 201-1234
(316) 201-1673
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
10/22/2020
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