Healthcare Provider Details

I. General information

NPI: 1962141887
Provider Name (Legal Business Name): PARK COUNTY SCHOOL DISTRICT 6
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 CODY AVE
CODY WY
82414-4115
US

IV. Provider business mailing address

919 CODY AVE
CODY WY
82414-4115
US

V. Phone/Fax

Practice location:
  • Phone: 307-527-6332
  • Fax:
Mailing address:
  • Phone: 307-527-6332
  • Fax:

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: MRS. KENDAL WEMHOFF
Title or Position: STUDENT SUPPORT SERVICES ADMIN ASSI
Credential:
Phone: 307-527-6332