Organization
CENTER FOR ADVANCED GYNECOLOGY REVOCABLE TRUST
Active
Parent organization
COTTON-O'NEIL CLINIC REVOCABLE TRUST
Organization subpart
Yes
Provider details
NPI number
Legal business name
COTTON-O'NEIL CLINIC REVOCABLE TRUST
Authorized official
MS. DEBRA YOCUM CPA (VICE PRESIDENT)
(785) 354-9591
Entity
Organization
Contact information
Practice address
823 SW MULVANE ST, TOPEKA, KS 66606-1764
(785) 270-8070
(785) 270-8071
Mailing address
823 SW MULVANE ST, TOPEKA, KS 66606-1764
(785) 270-8070
(785) 270-8071
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200302660A
—
KS
Enumeration date
12/11/2006
Last updated
09/17/2008
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