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Individual

DR. MARTIN R FUNK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1 E 2ND ST, CHANUTE, KS 66720-2460
(620) 431-2300
Mailing address
PO BOX 497, CHANUTE, KS 66720-0497
(620) 431-2300

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1351-3
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100219180A
KS
Enumeration date
09/19/2005
Last updated
02/22/2011
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