Provider Demographics
NPI:1336606748
Name:HULLINGER, WESLEY FARRELL
Entity Type:Individual
Prefix:MR
First Name:WESLEY
Middle Name:FARRELL
Last Name:HULLINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 W 80TH AVE N # 21
Mailing Address - Street 2:
Mailing Address - City:CONWAY SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:67031-8057
Mailing Address - Country:US
Mailing Address - Phone:620-960-5725
Mailing Address - Fax:
Practice Address - Street 1:2201 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3314
Practice Address - Country:US
Practice Address - Phone:620-960-5725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer