LOGAN KALE BANISTER

DERBY, KS
NPI1154551828
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy152W00000X Optometrist
(Licence: KS  1856)
Enumeration Date2009-07-16
Last Update Date2009-08-28
Business Address
Dr. LOGAN KALE BANISTER O.D.
1626 E MADISON AVE
DERBY, KS 67037-2076
Phone number: 316-788-1535
Mailing Address
Dr. LOGAN KALE BANISTER O.D.
1626 E MADISON AVE
DERBY, KS 67037-2076
Phone number: 316-788-1535
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