Organization
COUNTY OF TREGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA L PARKE (ADMINISTRATOR)
(785) 743-6348
Entity
Organization
Contact information
Practice address
201 N MAIN, WAKEENEY, KS 67672
(785) 743-6348
(785) 743-5428
Mailing address
201 N MAIN, WAKEENEY, KS 67672
(785) 743-6348
(785) 743-5428
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100116120A
—
KS
01
—
629620
HEALTHWAVE
—
Enumeration date
11/15/2006
Last updated
09/06/2013
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