Individual
DR. GARY L. BEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
300 W LAUREL ST, INDEPENDENCE, KS 67301-3315
(620) 331-2112
(620) 331-2147
Mailing address
PO BOX 47, INDEPENDENCE, KS 67301-0047
(620) 331-2112
(620) 331-2147
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1294-3
KS
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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