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General NPI Number Information
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NPI Number | 1467734467
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Entity Type | Organization
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Legal Business Name | WICHERT OPTOMETRY LLC
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 6 E 2ND AVE
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City | HUTCHINSON
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State | KS
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Zip | 67501-7102
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Country | US
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Telephone | 620-663-6060
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Fax | 620-663-4253
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Provider Business Mailing Address
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Address Line | 6 E 2ND AVE
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City | HUTCHINSON
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State | KS
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Zip | 67501-7102
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Country | US
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Telephone | 620-663-6060
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Fax | 620-663-4253
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Authorized Official
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Title or Position | DOCTOR/ OWNER
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Name | DR. BRENT WICHERT
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Credential | O.D.
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Telephone | 620-663-6060
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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 | 1908
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License Number State | KS
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