Organization
MIDAMERICARE LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG A ERISMAN PSYD (PRESIDENT)
(816) 516-7114
Entity
Organization
Contact information
Practice address
6301 E 125TH ST, GRANDVIEW, MO 64030-1884
(816) 516-7114
Mailing address
2900 SW 13TH ST, LEES SUMMIT, MO 64081-3800
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2007006349
MO
Other
Enumeration date
03/24/2010
Last updated
03/24/2010
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