Individual
LARRY C WENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2516 W PENNWAY ST, KANSAS CITY, MO 64108-2413
(816) 471-0305
Mailing address
2516 W PENNWAY ST, KANSAS CITY, MO 64108-2413
(816) 471-0305
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary
11444592
MO
Other
Enumeration date
06/30/2006
Last updated
07/09/2007
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