NPI | 1912004557 |
---|---|
Doing Business As | DBA JACKSON & BAALMAN, DOCTORS OF OPTOMETRY |
Entity Type | Organization |
Authorized Contact | RONALD MORRIS JACKSON President 316-722-6452 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KS 0982-3) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1293-3) |
Enumeration Date | 2006-09-17 |
Last Update Date | 2012-03-30 |