| NPI | 1538309620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY P NICKEL Optomtrist 620-331-0910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KS 09562) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2009-03-03 |