Healthcare Provider Details

I. General information

NPI: 1730355934
Provider Name (Legal Business Name): JOPLIN ASSOCIATION FOR THE BLIND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S SCHIFFERDECKER AVE
JOPLIN MO
64801-3317
US

IV. Provider business mailing address

311 S SCHIFFERDECKER AVE
JOPLIN MO
64801-3317
US

V. Phone/Fax

Practice location:
  • Phone: 417-623-5721
  • Fax: 417-623-1968
Mailing address:
  • Phone: 417-623-5721
  • Fax: 417-623-1968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. STEPHANIE MANN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 417-623-5721