Individual
ANTHONY JAMISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2825 N 109TH ST, KANSAS CITY, KS 66109-4410
(913) 944-0265
Mailing address
7180 W 107TH ST STE 1, OVERLAND PARK, KS 66212-2523
(913) 944-0265
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
K01889233
KS
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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