Organization
BRISENO KENNEY MEDICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARA BRISENO MD (OWNER)
(660) 851-4585
Entity
Organization
Contact information
Practice address
402 N LEE ST, LEETON, MO 64761-8200
(660) 851-4585
Mailing address
PO BOX 65, LEETON, MO 64761-0065
(660) 851-4585
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
06/26/2020
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