Individual
JEFF WONGSKHALUANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21020 W 151ST ST, GRIN EYE CARE, OLATHE, KS 66061-7200
(913) 829-5511
Mailing address
21020 W 151ST ST, GRIN EYE CARE, OLATHE, KS 66061-7200
(913) 829-5511
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
04--37827
KS
207W00000X
Ophthalmology Physician
2013021811
MO
Other
Enumeration date
07/14/2009
Last updated
10/06/2016
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