Individual
BETTY J CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
218 W RUTLEDGE ST, SUITE 1, YATES CENTER, KS 66783-1240
(620) 625-3311
(620) 625-2446
Mailing address
1851 N WEBB RD, ATTN FLR2, WICHITA, KS 67206-3413
(316) 636-2010
(316) 858-3830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
15243
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100321070A
—
KS
01
—
410040025
RAILROAD MEDICARE
—
Enumeration date
03/01/2006
Last updated
12/05/2013
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