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General NPI Number Information
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NPI Number | 1497382204
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Entity Type | Organization
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Legal Business Name | LIMESTONE EYE CARE LLC
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 4320 W 6TH STREET SUITE 103
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City | LAWRENCE
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State | KS
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Zip | 66049
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Country | US
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Telephone | 785-842-1242
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Fax | 785-842-3557
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Provider Business Mailing Address
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Address Line | 4320 W 6TH STREET SUITE 103
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City | LAWRENCE
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State | KS
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Zip | 66049
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Country | US
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Telephone | 785-842-1242
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Fax | 785-842-3557
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Authorized Official
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Title or Position | OWNER
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Name | JACOB WILLIAM LETOURNEAU
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Credential | OD
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Telephone | 785-842-1242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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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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