Organization
MISSOURI PHYSICIANS EYECARE GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING SUPERVISOR)
(561) 612-4531
Entity
Organization
Contact information
Practice address
1415 E BATTLEFIELD ST, SPRINGFIELD, MO 65804-3701
(561) 275-2020
(561) 275-2030
Mailing address
3801 S CONGRESS AVE, PALM SPRINGS, FL 33461-4140
(561) 275-2020
(561) 275-2030
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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