Organization
GRENE VISION GROUP LLC
Active
Other names
Grene Vision Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL K PAGE (CFO)
(316) 609-2120
Entity
Organization
Contact information
Practice address
121 OLD MILL ST, BUHLER, KS 67522-2228
(620) 543-2400
(620) 543-2496
Mailing address
1851 N WEBB RD, WICHITA, KS 67206-3413
(316) 858-3831
(316) 858-3830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100217500A
—
KS
Enumeration date
12/23/2016
Last updated
12/23/2016
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