Individual
DR. MARK RAY KILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19550 E 39TH ST S, SUITE 415, INDEPENDENCE, MO 64057-2303
(816) 254-9595
(816) 836-3810
Mailing address
14607 GRANADA ST, LEAWOOD, KS 66224-3703
(913) 544-1956
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
107716
MO
Other
Enumeration date
05/19/2006
Last updated
09/06/2007
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