Most Relevant Information
Provider Data
| NPI Number: | 1003470295 |
| Provider Name: | CHIZITAM IBEZIM |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/24/2019 |
| Last Updated: | 04/24/2019 |
Provider Practice Location
2411 HOLMES ST
KANSAS CITY
MO
641082741
Practice Location Phone/Fax
| Phone: | 8162351808 |
| Fax: |
Provider Mailing Location
2411 HOLMES ST
KANSAS CITY
MO
641082741
Provider Mailing Phone/Fax
| Phone: | 8162351808 |
| Fax: |