Individual
CHARLES A BANKS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6708 RAYTOWN RD, RAYTOWN, MO 64133-5272
(816) 353-1872
(816) 353-5022
Mailing address
6708 RAYTOWN RD, RAYTOWN, MO 64133-5272
(816) 353-1872
(816) 353-5022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02112
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T02112
LICENSE
MO
Enumeration date
12/02/2005
Last updated
07/08/2007
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