Individual
CLSUDIO REBOSURA DECENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
117 ROCK CREEK LOOP, LANSING, KS 66043-6211
(913) 250-0468
Mailing address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0418828
KS
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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