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General NPI Number Information
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NPI Number | 1831145010
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Entity Type | Organization
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Legal Business Name | MELISSA R KEUSLER, OD, PA
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6110 W KELLOGG DR SUITE #1
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City | WICHITA
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State | KS
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Zip | 67209-2361
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Country | US
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Telephone | 316-260-8788
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Fax | 316-943-8787
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Provider Business Mailing Address
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Address Line | 6110 W KELLOGG DR SUITE #1
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City | WICHITA
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State | KS
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Zip | 67209-2361
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Country | US
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Telephone | 316-260-8788
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Fax | 316-943-8787
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | MELISSA R KEUSLER
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Credential | O.D.
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Telephone | 316-260-8788
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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 | 1465-3
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License Number State | KS
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