Organization
CLEAR VISION EYE CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY LU O.D. (OPTOMETRIST)
(870) 762-0711
Entity
Organization
Contact information
Practice address
3700 E MAIN ST, BLYTHEVILLE, AR 72315-6881
(870) 762-0711
Mailing address
3700 E MAIN ST, BLYTHEVILLE, AR 72315-6881
(870) 762-0711
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2653
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184803722
—
AR
Enumeration date
10/03/2012
Last updated
10/03/2012
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