Organization
SAINT LUKE'S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY HOVERSTON MANAGEMENT (SUPERVISOR)
(816) 502-8828
Entity
Organization
Contact information
Practice address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
(816) 502-8828
(816) 502-7041
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
(816) 502-8828
(816) 502-7041
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
MO
Other
Enumeration date
06/01/2016
Last updated
07/21/2022
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