MEDICARE: KATHRYN WETTENGEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	1673	KS

General Provider Information

NPI Number	:	1164964425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN WETTENGEL

Provider Business Mailing Address
First Line	:	1925 MAIN ST
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-2549
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 MAIN ST
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-2549
Country	:	US
Telephone Number	:	620-603-6445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2016
Last Update Date	:	11/17/2016

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Directions to “ KATHRYN WETTENGEL ” Practice Location

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