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NPI Code Detail

MEDICARE: KUNKEL-SNYDER OPTOMETRIC, P.C

MEDICARE: KUNKEL-SNYDER OPTOMETRIC, P.C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist643SD

General Provider Information

NPI Number : 1376733949
Entity Type Code : Organization
Provider Name (Legal Business Name) : KUNKEL-SNYDER OPTOMETRIC, P.C
Provider Business Mailing Address
First Line : 1225 4TH ST NE
Second Line :
City : WATERTOWN
State : SD
Zip : 57201-1204
Country : US
Telephone Number : 605-882-4175
Fax Number : 605-882-2962
Provider Business Practice Location Address
First Line : 1225 4TH ST NE
Second Line :
City : WATERTOWN
State : SD
Zip : 57201-1204
Country : US
Telephone Number : 605-882-4175
Fax Number : 605-882-2962
Authorized Official
Title or Position : PRESIDENT
Name : DR. MATTHEW C KUNKEL
Credential : O.D
Telephone Number : 605-882-4175
Provider Enumeration Date : 07/30/2007
Last Update Date : 12/05/2007

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Directions to “KUNKEL-SNYDER OPTOMETRIC, P.C ” Practice Location

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