Organization
MEL MEDIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE ANTOINETTE MILLER (AUTHORIZED OFFICIAL)
(419) 631-0848
Entity
Organization
Contact information
Practice address
1610 WASHINGTON BLVD, KANSAS CITY, KS 66102-2842
(419) 631-0848
Mailing address
PO BOX 512, BONNER SPRINGS, KS 66012-0512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/13/2020
Last updated
02/18/2020
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