Organization
EYECARE SPECIALTIES OF MISSOURI LLC
Active
Other names
Eyecare Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT H LIESEMEYER OD (OWNER)
(660) 826-6161
Entity
Organization
Contact information
Practice address
3403 W 10TH ST, SEDALIA, MO 65301-2112
(660) 826-6161
(660) 826-8197
Mailing address
601 E RUSSELL AVE, SUITE A, WARRENSBURG, MO 64093-9605
(660) 747-2020
(660) 747-0574
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02629
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312338908
—
MO
Enumeration date
11/13/2006
Last updated
07/02/2015
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