Organization
EYE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN K.E. CARL O.D. (OPTOMETRIST)
(660) 826-2642
Entity
Organization
Contact information
Practice address
1200 WINCHESTER DR, SEDALIA, MO 65301-2467
(660) 826-2642
(660) 826-6748
Mailing address
1200 WINCHESTER DR, SEDALIA, MO 65301-2467
(660) 826-2642
(660) 826-6748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2004017484
MO
152W00000X
Optometrist
Primary
T02658
MO
Other
Enumeration date
07/31/2009
Last updated
01/18/2011
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