Organization
KILGORE VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA CIKANEK (PRACTICE ADMINISTRATOR)
(870) 741-1910
Entity
Organization
Contact information
Practice address
105 SAWGRASS PT, HARRISON, AR 72601-3072
(870) 741-1910
Mailing address
PO BOX 444, MOUNTAIN HOME, AR 72654-0444
(870) 424-4900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124170360
PTAN
AR
Enumeration date
01/17/2007
Last updated
01/07/2010
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