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Individual

DR. ETHAN CHANLIONGCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
4400 BROADWAY BLVD STE 106, KANSAS CITY, MO 64111-3395
(816) 931-0100
(816) 931-3677
Mailing address
8961 METCALF AVE APT 553, OVERLAND PARK, KS 66212-1588
(417) 521-9400

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2025034545
MO

Other

Enumeration date
08/18/2025
Last updated
08/18/2025
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