Organization
MID-KANSAS INTERVENTIONAL MONITORING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA SULLIVAN (BILLING MANAGER)
(214) 269-3875
Entity
Organization
Contact information
Practice address
3226 N GREY MEADOW ST, WICHITA, KS 67205-8715
(214) 269-3875
(903) 328-6568
Mailing address
PO BOX 268953, OKLAHOMA CITY, OK 73126-8953
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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