Organization
THE OUTLET PLACE FOR WOMEN
Active
Organization
THE OUTLET PLACE FOR WOMEN
Active
Other names
Outlet Place for Women The
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DETRONNE COULSON (PRESIDENT)
(816) 984-4841
Entity
Organization
Contact information
Practice address
1308 W TRUMAN RD, INDEPENDENCE, MO 64050-3433
(816) 984-4841
Mailing address
3401 BROADWAY ST # 16, KANSAS CITY, MO 64111-2403
(816) 984-4841
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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