Organization
DAN R BOARDSEN OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAN R BOARDSEN OD (OWNER)
(660) 263-3737
Entity
Organization
Contact information
Practice address
541 WEST REED, MOBERLY, MO 65270
(660) 263-3737
(660) 263-2375
Mailing address
PO BOX 400, MOBERLY, MO 65270-0400
(660) 263-3737
(660) 263-2375
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02681
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312290307
—
MO
01
—
431466559
VSP
—
01
—
5221
DAVIS VISION
—
Enumeration date
10/19/2006
Last updated
09/30/2014
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