Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1770706947 |
---|---|
Provider Name | Mrs. Marguerite Bengtson |
First Address | Shawnee, KS 66226-3867 |
Second Address | Olathe, KS 66062-2547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |