Individual
MOHAMED BENKHADRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12412 MONROE AVE, GRANDVIEW, MO 64030-1529
(913) 206-3476
Mailing address
1101 HAMPTON DR., RAYMORE, MO 64083-4010
(913) 206-3476
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
2015/01
MO
Other
Enumeration date
08/12/2015
Last updated
12/13/2016
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