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General NPI Number Information
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NPI Number | 1790708873
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Entity Type | Organization
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Legal Business Name | LENTZ ENTERPRISES LLC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 1223 N ROCK RD BLDG C
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City | WICHITA
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State | KS
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Zip | 67206-1277
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Country | US
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Telephone | 316-634-2020
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Fax | 316-634-2025
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Provider Business Mailing Address
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Address Line | 1223 N ROCK RD BLDG C
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City | WICHITA
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State | KS
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Zip | 67206-1277
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Country | US
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Telephone | 316-634-2020
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Fax | 316-634-2025
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | DR. THOMAS RICHARD LENTZ
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Credential | O.D.
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Telephone | 316-634-2020
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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 |
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License Number State |
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