Organization
MOHAVE EYE CENTER, LTD
Active
Parent organization
MOHAVE EYE CENTER, LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOHAVE EYE CENTER, LTD
Authorized official
KATHRINE L WINTERS (ADMINISTRATOR)
(928) 753-2106
Entity
Organization
Contact information
Practice address
1925 FLORENCE AVE, KINGMAN, AZ 86401-4617
(928) 753-2106
(928) 753-4283
Mailing address
2005 INJO DR, SUITE 102, LAKE HAVASU CITY, AZ 86403-5874
(928) 753-2106
(928) 753-4283
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100290003
PTAN
AZ
01
—
Z20872
MEDICARE
AZ
Enumeration date
10/26/2016
Last updated
10/26/2016
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