Organization
THE RUSSELL EYECARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD T PREMER OD (OWNER)
(620) 792-2020
Entity
Organization
Contact information
Practice address
702 N KANSAS ST, RUSSELL, KS 67665-2043
(785) 483-2451
Mailing address
2601 10TH ST, GREAT BEND, KS 67530-4253
(620) 792-2020
(620) 792-2583
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/23/2017
Last updated
06/23/2017
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