Individual
SAMUEL CODY BROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-8500
(913) 588-6970
Mailing address
2028 BRISTOW ST, KANSAS CITY, KS 66103-2111
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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