Organization
KANSAS CITY OPTICAL, LLC
Active
Other names
Optica Latina, Eye Care Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BROBERG OD (OWNER)
(913) 717-9296
Entity
Organization
Contact information
Practice address
4609 INDEPENDENCE AVE, KANSAS CITY, MO 64124-2927
(913) 717-9296
Mailing address
13803 W 82ND TER, LENEXA, KS 66215-4168
(913) 717-9296
(816) 817-3769
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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