Organization
BENNETT EYECARE MIDWEST, LLC
Active
Parent organization
BENNETT EYECARE MIDWEST, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BENNETT EYECARE MIDWEST, LLC
Authorized official
DR. ABBIE NELL RONDEAU (CREDENTIALING OFFICER)
(816) 858-2522
Entity
Organization
Contact information
Practice address
1504 N CHURCH RD STE C, LIBERTY, MO 64068-7163
(816) 781-3442
(816) 415-9743
Mailing address
2441 NW PRAIRIE VIEW RD, PLATTE CITY, MO 64079-7627
(816) 858-2522
(816) 858-2946
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407839756
NPI
—
01
—
1528041860
NPI
—
01
—
1669455747
NPI
MO
01
—
1811159361
NPI
—
05
—
312478241
—
MO
05
—
316013606
—
MO
05
—
318693827
—
MO
05
—
505840207
—
MO
05
—
535840201
—
MO
Enumeration date
10/28/2008
Last updated
04/01/2019
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