Organization
SPECS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNY NGUYEN (OWNER)
(913) 390-0300
Entity
Organization
Contact information
Practice address
14971 W 119TH ST, OLATHE, KS 66062-9656
(913) 390-0300
Mailing address
14971 W 119TH ST, OLATHE, KS 66062-9656
(913) 390-0300
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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