Individual
STACEY NIEHUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
121 W 4TH ST # AT, HOLTON, KS 66436-1701
(785) 364-5000
Mailing address
121 W 4TH ST # AT, HOLTON, KS 66436-1701
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2058
KS
Other
Enumeration date
06/19/2017
Last updated
12/12/2018
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