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Individual

GRETCHEN ELIZABETH BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
2040 HUTTON RD, SUITE 102, KANSAS CITY, KS 66109-4526
(913) 299-3700
Mailing address
2040 HUTTON RD, SUITE 102, KANSAS CITY, KS 66109-4526
(913) 299-3700

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
05-33433
KS
208000000X
Pediatrics Physician
2003014690
MO

Other

Enumeration date
10/04/2005
Last updated
01/26/2012
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