Individual
COLLEEN LOO-GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2607
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.138014
IL
207Q00000X
Family Medicine Physician
Primary
04-40664
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2012
Last updated
08/27/2020
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