Individual
CHARLES CORY HALLACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3066 N KENTUCKY ST, IOLA, KS 66749-1951
(620) 365-1000
Mailing address
303 S PINE ST, ARMA, KS 66712-4008
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
557616
KS
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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