Organization
LEWIS COUNTY VISION SOURCE PC
Active
Other names
Dr. Kelly Padgett
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MICHELE PADGETT OD (OWNER)
(360) 736-4447
Entity
Organization
Contact information
Practice address
1805 COOKS HILL RD, CENTRALIA, WA 98531-9072
(360) 736-4447
(360) 807-0324
Mailing address
1805 COOKS HILL RD, CENTRALIA, WA 98531-9072
(360) 736-4447
(360) 807-0324
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
60236154
WA
Other
Enumeration date
09/24/2015
Last updated
12/23/2015
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