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Individual

DR. AMY RENEE GOERTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
12111 W MAPLE ST STE 125, WICHITA, KS 67235-8756
(316) 832-0088
(316) 832-0029
Mailing address
11621 W 17TH ST N, WICHITA, KS 67212-6968
(316) 260-9736
(316) 832-0029

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1683
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200277350A
KS
Enumeration date
09/21/2005
Last updated
08/09/2012
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