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Individual

MRS. AMANDA LEE HURSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D,

Contact information

Practice address
201 N VINE ST, EL DORADO, KS 67042-2055
(316) 321-4020
(316) 321-0115
Mailing address
201 N VINE ST, EL DORADO, KS 67042-2055
(316) 321-4020
(316) 321-0115

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1817
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200664750
KS
Enumeration date
08/04/2008
Last updated
01/04/2013
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