Organization
PRO PHYSICIANS CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON D JON TRYGGESTAD (CEO)
(972) 573-4611
Entity
Organization
Contact information
Practice address
2077 N WEBB RD, WICHITA, KS 67206-3411
(316) 869-2280
(512) 583-2001
Mailing address
PO BOX 678234, DALLAS, TX 75267-8234
(316) 869-2280
(512) 583-2001
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
0426447
KS
Other
Enumeration date
05/28/2014
Last updated
07/11/2014
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