Organization
MY SACRED HOME II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MANZANO MD (BILLING AND CODING MANAGER)
(316) 440-4820
Entity
Organization
Contact information
Practice address
7829 E ROCKHILL ST STE 406, WICHITA, KS 67206-3915
(316) 440-4820
(316) 440-4851
Mailing address
7829 E ROCKHILL ST STE 406, WICHITA, KS 67206-3915
(316) 440-4820
(316) 440-4851
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/12/2009
Last updated
06/12/2009
About Stedi
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