NPI 1275075103

Northwest Kansas Tech College

Organisation Preferred Provider Organization Goodland, KS

Practice location

Address: 1209 Harrison Ave, Goodland, KS 67735-3441
Phone: (785) 890-1539
Mailing address: 417 Broadway, Goodland, KS 67735

Authorised official

Name: Shelby Ann Heatwole
Title: Head Athletic Trainer
Phone: (620) 290-4687

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence XSB886824257 (KS)

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Registry record

NPI: 1275075103
Entity type: Organization
NPI issued: 9 Nov 2016
Record last updated: 9 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.