Individual
DAVID TINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
806 COLORADO AVE, HOLTON, KS 66436-1329
(785) 364-6128
Mailing address
806 COLORADO AVE, HOLTON, KS 66436-1329
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
KS
3747P1801X
Personal Care Attendant
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200421710A
—
KS
Enumeration date
08/30/2013
Last updated
08/30/2013
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