Organization
CHILDRENS VISION AND LEARNING CENTER, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD GRAEBE O.D. (OWNER)
(859) 879-0089
Entity
Organization
Contact information
Practice address
105 CROSSFIELD DR, VERSAILLES, KY 40383-1444
(859) 879-3665
(859) 879-3662
Mailing address
105 CROSSFIELD DR, VERSAILLES, KY 40383-1444
(859) 879-3665
(859) 879-3662
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
1044-DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77903557
—
KY
Enumeration date
04/11/2007
Last updated
04/14/2015
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