Individual
DR. LORI D BERWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
21020 W 151ST ST, OLATHE, KS 66061-7200
(913) 829-5511
(913) 829-5571
Mailing address
PO BOX 219241, KANSAS CITY, MO 64121-9241
(913) 829-5511
(913) 829-5571
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1576
KS
152W00000X
Optometrist
2000145672
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00167129
RAILROAD MEDICARE
KS
Enumeration date
02/22/2006
Last updated
06/11/2012
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