| NPI | 1255543021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL DAVENPORT Insurance Specialist 316-691-3955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-02-20 |