Organization
INTERNATIONAL EYECARE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY LEE SHORT (CREDENTIALING MANAGER)
(618) 462-9818
Entity
Organization
Contact information
Practice address
1702 N BALTIMORE ST, KIRKSVILLE, MO 63501-2485
(660) 665-6262
Mailing address
1702 N BALTIMORE ST, KIRKSVILLE, MO 63501-2485
(660) 665-6262
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
01/22/2008
Last updated
01/20/2021
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