Healthcare Provider Details

I. General information

NPI: 1518292887
Provider Name (Legal Business Name): RAWLINS COUNTY USD 105
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N 4TH ST SUITE 1
ATWOOD KS
67730-1708
US

IV. Provider business mailing address

205 N 4TH ST SUITE 1
ATWOOD KS
67730-1708
US

V. Phone/Fax

Practice location:
  • Phone: 785-626-3236
  • Fax: 785-626-3083
Mailing address:
  • Phone: 785-626-3236
  • Fax: 785-626-3083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MARK WOLTERS
Title or Position: SUPERINTENDENT
Credential:
Phone: 785-626-3236