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1679399448
SHANE GOLDWATER
WICHITA, KS
NPI
1679399448
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2024-11-26
Last Update Date
2024-11-26
Business Address
SHANE GOLDWATER
1319 W MAY ST
WICHITA, KS 67213-3505
Phone number: 316-223-7159
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Mailing Address
SHANE GOLDWATER
1319 W MAY ST
WICHITA, KS 67213-3505
Phone number: 316-223-7159
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