Organization
KEITH WALKER OPTICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA J LAIS (OPTICIAN)
(417) 623-3448
Entity
Organization
Contact information
Practice address
2632 CUNNINGHAM AVE, JOPLIN, MO 64804-1542
(417) 623-3448
Mailing address
2632 CUNNINGHAM AVE, JOPLIN, MO 64804-1542
(417) 623-3448
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320412703
—
MO
Enumeration date
02/19/2008
Last updated
02/21/2008
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