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Individual

DR. ANDREW W PIESTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
104 WEST C AVE, KINGMAN, KS 67068-1313
(620) 532-3154
(620) 532-5662
Mailing address
104 WEST C AVE, KINGMAN, KS 67068-1313
(620) 532-3154
(620) 532-5662

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1925
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200966630A
KS
01
P01102034
RR MEDICARE
KS
Enumeration date
08/10/2012
Last updated
01/08/2013
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