Organization
ENVISION EYECARE, LLC
Active
Other names
Envision Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA CLYDE CANTRELL O.D. (EXECUTIVE MEMBER)
(816) 246-7779
Entity
Organization
Contact information
Practice address
215 SE STATE ROUTE 291, LEES SUMMIT, MO 64063-2939
(816) 246-7779
(816) 246-7780
Mailing address
215 SE STATE ROUTE 291, LEES SUMMIT, MO 64063-2939
(816) 246-7779
(816) 246-7780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2003000960
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39170011
BCBS
MO
Enumeration date
07/31/2006
Last updated
07/01/2008
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