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Individual

DR. KEVIN B. CLINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.,FCOVD

Contact information

Practice address
12111 W MAPLE ST, WICHITA, KS 67235-8755
(316) 942-7496
(316) 239-2557
Mailing address
415 SE LOUIS DR, MULVANE, KS 67110-1205
(316) 777-0022
(316) 777-4342

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1295
KS
152WP0200X
Pediatric Optometrist
1295
KS
152WV0400X
Vision Therapy Optometrist
Primary
1295
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100218790C
KS
Enumeration date
08/17/2006
Last updated
05/31/2018
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