Individual
KENNETH D HASTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
605 N MAIN ST, SHELBYVILLE, TN 37160-3210
(931) 684-2020
(931) 684-7000
Mailing address
605 N MAIN ST, SHELBYVILLE, TN 37160-3210
(931) 684-2020
(931) 684-7000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1018
TN
332H00000X
Eyewear Supplier
0752740001
TN
Other
Enumeration date
01/30/2007
Last updated
04/22/2008
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