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General NPI Number Information
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NPI Number | 1164551024
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY EYE CARE INC
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 1724 W KEARNEY ST STE 116
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City | SPRINGFIELD
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State | MO
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Zip | 65803-1692
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Country | US
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Telephone | 417-865-4448
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Fax | 417-862-8704
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Provider Business Mailing Address
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Address Line | 1724 W KEARNEY ST STE 116
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City | SPRINGFIELD
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State | MO
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Zip | 65803-1692
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Country | US
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Telephone | 417-865-4448
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Fax | 417-862-8704
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Authorized Official
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Title or Position | OWNER
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Name | ELI B LEMONIER
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Credential | OD
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Telephone | 417-865-4448
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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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