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General NPI Number Information
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NPI Number | 1265517288
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Entity Type | Organization
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Legal Business Name | ROLLENHAGEN EYE CARE
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 1801 SW WANAMAKER RD STE F9
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City | TOPEKA
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State | KS
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Zip | 66604-3804
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Country | US
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Telephone | 785-272-6900
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Fax | 785-272-6951
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Provider Business Mailing Address
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Address Line | 1801 SW WANAMAKER RD STE F9
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City | TOPEKA
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State | KS
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Zip | 66604-3804
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Country | US
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Telephone | 785-272-6900
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Fax | 785-272-6951
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. SUSAN R ROLLENHAGEN
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Credential | O.D.
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Telephone | 785-272-6900
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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 | KS1559
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License Number State | KS
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