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General NPI Number Information
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NPI Number | 1760570295
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Entity Type | Organization
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Legal Business Name | NEVADA OPTOMETRIC CENTER, INC.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 120 S WASHINGTON ST
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City | NEVADA
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State | MO
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Zip | 64772-3330
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Country | US
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Telephone | 417-667-2560
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 308
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City | NEVADA
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State | MO
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Zip | 64772-0308
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Country | US
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Telephone | 417-667-2560
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONNIE J. HATCH
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Credential | O.D.
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Telephone | 417-667-2560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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