| NPI | 1548476344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ROBERT KICKHAM Optometrist Owner 417-890-7599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO T02770) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2016-02-05 |