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General NPI Number Information
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NPI Number | 1295752178
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Entity Type | Individual
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Provider Name | TED J ROSENTRETER O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 975 N MUR LEN RD SUITE D
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City | OLATHE
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State | KS
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Zip | 66062-1861
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Country | US
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Telephone | 913-764-5995
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Fax | 913-764-6032
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Provider Business Mailing Address
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Address Line | 975 N MUR LEN RD SUITE D
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City | OLATHE
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State | KS
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Zip | 66062-1861
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Country | US
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Telephone | 913-764-5995
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Fax | 913-764-6032
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | KS 1126-3
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License Number State | KS
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