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Individual

DR. LARRY DAVID MITNAUL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., M.P.H., M.S.

Contact information

Practice address
1515 S CLIFTON AVE STE 300, WICHITA, KS 67218-2953
(316) 858-0550
(316) 858-0596
Mailing address
1515 S CLIFTON AVE STE 300, WICHITA, KS 67218-2953
(316) 858-0550
(316) 858-0596

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
04-40194
KS
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/14/2012
Last updated
07/21/2022
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