Organization
STATE LINE EYE CARE CENTER, PC
Active
Other names
Cass County Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAM (LILY) S YOHN (OFFICE MANAGER)
(816) 444-2900
Entity
Organization
Contact information
Practice address
424 E NORTH AVE, BELTON, MO 64012-2017
(816) 322-6100
(816) 331-1444
Mailing address
7701 STATE LINE RD, KANSAS CITY, MO 64114-1635
(816) 444-2900
(816) 444-3304
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19517021
BCBS
MO
05
—
506190107
—
MO
Enumeration date
06/13/2008
Last updated
03/03/2015
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