Provider Demographics
NPI:1649408287
Name:CRADLE THRU COLLEGE CARE, LLC
Entity Type:Organization
Organization Name:CRADLE THRU COLLEGE CARE, LLC
Other - Org Name:CRADLE THRU COLLEGE CARE URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:METZL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-942-5437
Mailing Address - Street 1:1004 CARONDELET DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4801
Mailing Address - Country:US
Mailing Address - Phone:816-942-5437
Mailing Address - Fax:816-942-4830
Practice Address - Street 1:1004 CARONDELET DR
Practice Address - Street 2:SUITE 310
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4801
Practice Address - Country:US
Practice Address - Phone:816-942-5437
Practice Address - Fax:816-942-4830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRADLE THRU COLLEGE CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty