Individual
JACOB LANCE CLOWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 962-3070
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 962-3070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94-09202
KS
Other
Enumeration date
06/06/2017
Last updated
07/21/2022
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