Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 04-31345 | KS |
NPI | 1093748659 |
---|---|
Provider Name | Dr. Lilane J Reifenberg |
First Address | Manhattan, KS 66503-2403 |
Second Address | Saint Joseph, MO 64506-3488 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 08/07/2007 |