| NPI | 1194910869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BODEN Office Manager 316-832-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: KS 1239-2) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: KS 1239-2) |
| 152WP0200X Optometrist, Pediatrics (Licence: KS 1239-2) | |
| 152WS0006X Optometrist, Sports Vision (Licence: KS 1239-2) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: KS 1239-2) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: KS 1239-2) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2010-09-09 |