Organization
PROFESSIONAL EYECARE - BANNISTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE LORRAINE ROYER (MANAGED CARE MANAGER)
(913) 696-0092
Entity
Organization
Contact information
Practice address
5600 E BANNISTER RD RM 188, KANSAS CITY, MO 64192-1000
(816) 765-3310
(816) 765-3181
Mailing address
5600 E BANNISTER RD RM 188, KANSAS CITY, MO 64192-1000
(816) 765-3310
(816) 765-3181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2880
MO
Other
Enumeration date
01/17/2007
Last updated
08/22/2020
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