Organization
TRINA HEALTH-WITCHITA N.W., LLC
Active
Other names
Trina Health of Wichita
Organization subpart
No
Provider details
NPI number
Authorized official
DEANE' WALLACE (CREDENTIALING SPECIALIST)
(916) 571-9041
Entity
Organization
Contact information
Practice address
8414 W 13TH ST N, STE 200, WICHITA, KS 67212-2979
(214) 364-0304
(866) 713-4186
Mailing address
8414 W 13TH ST N, STE 200, WICHITA, KS 67212-2979
(214) 364-0304
(866) 713-4186
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
Other
Enumeration date
07/07/2015
Last updated
07/11/2017
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