Individual
ROGER A KLASSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7904 S 83RD ST, LAVISTA, NE 68128-2774
(402) 597-8990
(402) 597-8992
Mailing address
8504 S 100TH ST, LAVISTA, NE 68128-3072
(402) 597-8990
(402) 597-8992
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1055
NE
152W00000X
Optometrist
14293
KS
152W00000X
Optometrist
18002700
IN
152W00000X
Optometrist
2153
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025067700
—
NE
Enumeration date
08/03/2005
Last updated
07/08/2007
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