Organization
LINE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER ELLEN HANCOCK (OFFICE)
(316) 262-3444
Entity
Organization
Contact information
Practice address
750 AVENUE D WEST, KINGMAN, KS 67068
(316) 262-3444
(316) 262-3006
Mailing address
PO BOX 3172, WICHITA, KS 67201-3172
(316) 262-3444
(316) 262-3006
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100279560A
—
KS
01
—
110303
BCBS
KS
Enumeration date
04/19/2006
Last updated
06/30/2008
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