Provider Demographics
NPI:1508257742
Name:SOLOMON VALLEY VISION LLC
Entity Type:Organization
Organization Name:SOLOMON VALLEY VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHENEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-346-5437
Mailing Address - Street 1:101 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OSBORNE
Mailing Address - State:KS
Mailing Address - Zip Code:67473-2402
Mailing Address - Country:US
Mailing Address - Phone:785-346-5437
Mailing Address - Fax:785-346-5438
Practice Address - Street 1:101 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OSBORNE
Practice Address - State:KS
Practice Address - Zip Code:67473-2402
Practice Address - Country:US
Practice Address - Phone:785-346-5437
Practice Address - Fax:785-346-5438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1975152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty