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General NPI Number Information
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NPI Number | 1528024742
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Entity Type | Organization
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Legal Business Name | HEALTHY OPTIONS FOR PLANEVIEW
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 3620 E SUNNYBROOK LN SUITE C
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City | WICHITA
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State | KS
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Zip | 67210-1464
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Country | US
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Telephone | 316-651-5357
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Fax | 316-651-5357
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Provider Business Mailing Address
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Address Line | 4501 E 47TH ST S ROOM A104
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City | WICHITA
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State | KS
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Zip | 67210-1651
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Country | US
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Telephone | 316-978-8011
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Fax | 316-554-2650
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. RUTH B PICKARD
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Credential | PH.D
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Telephone | 316-978-5637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 60019
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License Number State | KS
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