Organization
INTRATHECAL CONSULTANT SERVICES
Active
Organization
INTRATHECAL CONSULTANT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KYONG SUN NICHOLSON (CEO)
(816) 878-4888
Entity
Organization
Contact information
Practice address
4212 NE KENNESAW RDG, LEES SUMMIT, MO 64064-1379
(816) 878-4888
Mailing address
4212 NE KENNESAW RDG, LEES SUMMIT, MO 64064-1379
(816) 878-4888
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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