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General NPI Number Information
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NPI Number | 1689845323
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Entity Type | Organization
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Legal Business Name | HART FAMILY EYECARE, LLC
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 808 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2023
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Country | US
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Telephone | 417-255-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 808 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2023
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Country | US
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Telephone | 417-255-2010
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE A HART
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Credential | O.D.
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Telephone | 417-255-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 2006018277
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2006018277
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License Number State | MO
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