Individual
DR. THOMAS A MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST
Contact information
Practice address
7701 FRONTAGE RD, SUITE A, OVERLAND PARK, KS 66204-2364
(913) 648-3072
(913) 648-6597
Mailing address
7701 FRONTAGE RD, SUITE A, OVERLAND PARK, KS 66204-2364
(913) 648-3072
(913) 648-6597
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KS1344
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200002230A
—
KS
Enumeration date
11/15/2006
Last updated
07/09/2007
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