Provider Demographics
NPI:1477588085
Name:CLINICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:CLINICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CAPPO
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:913-677-3553
Mailing Address - Street 1:8629 BLUEJACKET ST
Mailing Address - Street 2:STE 100
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1604
Mailing Address - Country:US
Mailing Address - Phone:913-677-3553
Mailing Address - Fax:913-677-3282
Practice Address - Street 1:8629 BLUEJACKET ST
Practice Address - Street 2:STE 100
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1604
Practice Address - Country:US
Practice Address - Phone:913-677-3553
Practice Address - Fax:913-677-3282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty