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General NPI Number Information
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NPI Number | 1013243666
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Entity Type | Organization
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Legal Business Name | FAMILY EYE CARE OF BELLEVILLE INC
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 1704 M ST
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City | BELLEVILLE
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State | KS
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Zip | 66935
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Country | US
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Telephone | 785-527-5700
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Fax | 785-527-5700
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Provider Business Mailing Address
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Address Line | P.O. BOX 38 1704 M ST
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City | BELLEVILLE
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State | KS
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Zip | 66935
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Country | US
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Telephone | 785-527-5700
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Fax | 785-527-5700
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RYAN JENNINGS
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Credential | OD
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Telephone | 785-527-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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