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Organization

DRS GLENN AND GLENN INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELANIE B BANKS (OFFICE MANAGER)
(785) 483-2451
Entity
Organization

Contact information

Practice address
702 N KANSAS, RUSSELL, KS 67665-0535
(785) 483-2451
(785) 483-4986
Mailing address
PO BOX 535, RUSSELL, KS 67665-0535
(785) 483-2451
(785) 483-4986

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11533
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100219210B
KS
Enumeration date
10/05/2006
Last updated
06/01/2016
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