Organization
HACKWORTH FAMILY EYE CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY HACKWORTH O.D. (PRESIDENT)
(913) 687-0032
Entity
Organization
Contact information
Practice address
508 CHEROKEE ST, LEAVENWORTH, KS 66048-2626
(913) 682-2020
Mailing address
4905 BRADSHAW ST, SHAWNEE, KS 66216-1429
(913) 687-0032
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1620
KS
Other
Enumeration date
04/07/2009
Last updated
07/28/2009
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