Individual
JOHN L. NIEGSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
101 N. BROADWAY, SUITE A, PITTSBURG, KS 66762-6601
(620) 232-1360
Mailing address
101 N. BROADWAY, SUITE A, PITTSBURG, KS 66762-6601
(620) 232-1360
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
NOT APPLICABLE
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4-0875
SALES TAX LICENSE NUMBER
KS
Enumeration date
01/12/2007
Last updated
07/08/2007
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