| NPI | 1720098643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE C MITCHELL O PT Ometrist 620-223-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: KS 1106-3) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| 152WL0500X Optometrist Low Vision Rehabilitation | |
| 152WP0200X Optometrist Pediatrics | |
| 152WS0006X Optometrist Sports Vision | |
| 152WV0400X Optometrist Vision Therapy | |
| 152WX0102X Optometrist Occupational Vision | |
| 152W00000X Optometrist | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |