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Organization

AMBER WAVES NEUROLOGY, CHARTERED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRENT W DAVIS MD (NEUROLOGIST)
(785) 309-0012
Entity
Organization

Contact information

Practice address
520 S SANTA FE AVE, SUITE 300, SALINA, KS 67401-4190
(785) 309-0012
Mailing address
PO BOX 1121, SALINA, KS 67402-1121
(785) 309-0012

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0428008
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00154557
RAILROAD MEDICARE
KS
Enumeration date
03/24/2006
Last updated
02/15/2008
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