Individual
MRS. MILAGROS PERIDO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
411 SUNSET DR, ELKHART, KS 67950-0997
(620) 697-2155
(620) 697-4275
Mailing address
PO BOX 997, ELKHART, KS 67950-0997
(620) 697-2155
(620) 697-4275
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
123105
KS
Other
Enumeration date
09/02/2005
Last updated
07/08/2007
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