Organization
KIM MOYER OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM E MOYER OD (OWNER)
(219) 866-5722
Entity
Organization
Contact information
Practice address
215 W KELLNER BLVD STE 12, RENSSELAER, IN 47978-2665
(219) 866-5722
Mailing address
215 W KELLNER BLVD STE 12, RENSSELAER, IN 47978-2665
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001961B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100210730C
—
IN
Enumeration date
02/10/2007
Last updated
05/25/2020
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