| NPI | 1003071887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM L PARK Member 316-440-1690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1798) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: KS 1798) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2011-04-14 |