Organization
BENNETT EYECARE MIDWEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABBIE RONDEAU-NELSON O.D. (CREDENTIALING OFFICER)
(816) 858-2522
Entity
Organization
Contact information
Practice address
3417 NW MILL DR, BLUE SPRINGS, MO 64015-3257
(816) 229-3001
(816) 229-9459
Mailing address
2441 NW PRAIRIE VIEW RD, PLATTE CITY, MO 64079-7627
(816) 858-2522
(816) 858-2946
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750548871
—
MO
Enumeration date
12/06/2012
Last updated
02/05/2014
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