Individual
LIA MARIE GAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2521 GLENN HENDREN DR STE 204, LIBERTY, MO 64068-3388
(816) 781-6066
(816) 792-5130
Mailing address
PO BOX 219672, KANSAS CITY, MO 64121-9672
(816) 781-6066
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/26/2016
Last updated
07/20/2022
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