Provider Demographics
NPI:1497520506
Name:KAW VALLEY WELLNESS CLINIC
Entity type:Organization
Organization Name:KAW VALLEY WELLNESS CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY HEALTH ADVOCATE
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSIER-DUVALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-228-2346
Mailing Address - Street 1:455 SE GOLF PARK BLVD # 120
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605-2862
Mailing Address - Country:US
Mailing Address - Phone:785-228-2346
Mailing Address - Fax:785-228-2337
Practice Address - Street 1:455 SE GOLF PARK BLVD # 120
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605-2862
Practice Address - Country:US
Practice Address - Phone:785-228-2346
Practice Address - Fax:785-228-2337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service