| NPI | 1932434982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON E. STAHL Owner 913-491-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KS 04-23098) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1427-3) |
| 174400000X Specialist (Licence: KS 04-28638) | |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2019-11-21 |