Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 04-37194 | KS |
NPI | 1275828535 |
---|---|
Provider Name | Peter L Loo |
First Address | Topeka, KS 66611-1200 |
Second Address | Topeka, KS 66611-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 08/12/2020 |