Organization
REJUVENATE LIGHT AND VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CADE JOHN KOWALLIS OD (OWNER)
(417) 604-0188
Entity
Organization
Contact information
Practice address
220 N MASSEY BLVD, NIXA, MO 65714-8324
(417) 374-1088
Mailing address
220 N MASSEY BLVD, NIXA, MO 65714-8324
(417) 374-1088
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
Other
Enumeration date
02/23/2026
Last updated
03/24/2026
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