Doctor Name: | MR. CHESTER IRVING |
NPI Number: | 1619143096 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 4031 E Harry St Wichita, KS - 672183724 |
Business Phone Number: | 3167717335 |
Business Fax Number: | 3167717201 |
Mailing Address: | 5411 S Mosley St, WICHITA |
State: | KS |
Postal Code: | 672163629 |
Phone Number: | 3167717335 |
Fax Number: | 3167717201 |
NPI Enumeration Date: | 05/05/2008 |
NPI Last Update Date: | 05/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |