| NPI | 1124049499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TEETER Practice Administrator 620-275-7248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-07-08 |