Graduated: 2012
NPI: 1891130936
Practice Locations (3)
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
8929 PARALLEL PKWY
KANSAS CITY, KS 661121689
9135964000
LIVEACTIVE MULTISPECIALTY PHYSICIAN GROUP LLC
6650 W 110TH ST, SUITE 220A
OVERLAND PARK, KS 662111501
9135493884
LIVEACTIVE MULTISPECIALTY PHYSICIAN GROUP LLC
500 NW 68TH ST, KINDRED HOSPITAL NORTHLAND
KANSAS CITY, MO 641182455
8164203600
Source: CMS National Downloadable File, September 2026.