Organization
WEST WICHITA FAMILY OPTOMETRISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W KISSLING O.D. (VICE PRESIDENT)
(316) 262-3716
Entity
Organization
Contact information
Practice address
1202 W MAPLE ST, WICHITA, KS 67213-3916
(316) 262-3716
(316) 262-0784
Mailing address
1202 W MAPLE ST, WICHITA, KS 67213-3916
(316) 262-3716
(316) 262-0784
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005347
BCBS
KS
Enumeration date
02/01/2006
Last updated
08/12/2008
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