| NPI | 1245382829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE LORRAINE ROYER Managed Care Manager 913-696-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO TO2880) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |