Individual
DR. KIRK M WANLESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 UNION AVE, SUITE B, MOBERLY, MO 65270-9469
(660) 263-4600
(660) 263-4640
Mailing address
1501 UNION AVE, SUITE B, MOBERLY, MO 65270-9469
(660) 263-4600
(660) 263-4640
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2004028847
MO
Other
Enumeration date
09/06/2005
Last updated
07/22/2014
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