Organization
HIESTERMAN FAMILY EYE CARE, LLC
Active
Other names
Ryan L. Hiesterman, O.D., LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN LEE HIESTERMAN O.D. (PRESIDENT)
(785) 632-6100
Entity
Organization
Contact information
Practice address
532 LINCOLN AVE, CLAY CENTER, KS 67432-2902
(785) 632-6100
(785) 632-6101
Mailing address
532 LINCOLN AVE, CLAY CENTER, KS 67432-2902
(785) 632-6100
(785) 632-6101
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1656
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200259350B
—
KS
01
—
481170
FIRST GUARD
KS
01
—
P00173182
RAILROAD MEDICARE
KS
Enumeration date
08/30/2006
Last updated
04/28/2008
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