Organization
KSB MEDICAL GROUP, INC.
Active
Other names
KSB Eye & Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN BRUCE FRAZIER (CFO)
(815) 285-5513
Entity
Organization
Contact information
Practice address
511 PALMYRA ST, DIXON, IL 61021-1953
(815) 284-2020
(815) 284-8326
Mailing address
PO BOX 841330, KANSAS CITY, MO 64184-1330
(816) 201-3331
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/22/2010
Last updated
12/29/2022
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