Organization
LAURIE FAMILY EYECARE, INC.
Active
Other names
Family Eyecare Associates
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN EVELAND OD (PRESIDENT)
(573) 374-5222
Entity
Organization
Contact information
Practice address
138 S. MAIN, SUITE C, LAURIE, MO 65037
(573) 374-5222
Mailing address
PO BOX 1185, LAURIE, MO 65038
(573) 374-5222
(573) 374-7351
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO3452
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN1000
RAILROAD MEDICARE
MO
Enumeration date
01/08/2008
Last updated
11/16/2011
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