Individual
MICHAEL KILONGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12328 CRAIG ST, OVERLAND PARK, KS 66213-1437
(512) 297-6083
Mailing address
12328 CRAIG ST, OVERLAND PARK, KS 66213-1437
(512) 297-6083
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
K032907550
KS
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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