Organization
CLARKSON OPTOMETRY MIDWEST INC.
Active
Other names
Eyecare Associates of Kentucky
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WACHTER (OWNER)
(636) 200-4393
Entity
Organization
Contact information
Practice address
43 INDUSTRIAL PKWY, CALVERT CITY, KY 42029-8416
(636) 200-4393
Mailing address
PO BOX 207170, DALLAS, TX 75320-7156
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1896DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306191218
RAILROAD
KY
05
—
7100312880
—
KY
Enumeration date
08/08/2014
Last updated
07/08/2019
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