Organization
KIDSTLC MEDICAL SERVICS, LLC
Active
Organization
KIDSTLC MEDICAL SERVICS, LLC
Active
Parent organization
KIDSTLC, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIDSTLC, INC
Authorized official
GORDON DOCKING (CEO)
(913) 324-3636
Entity
Organization
Contact information
Practice address
480 S ROGERS RD, OLATHE, KS 66062-1706
(913) 324-3636
(913) 324-3894
Mailing address
480 S ROGERS RD, OLATHE, KS 66062-1706
(913) 324-3636
(913) 324-3894
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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