Provider Demographics
NPI:1710500384
Name:WOOFTER, GENARE C (OD)
Entity Type:Individual
Prefix:DR
First Name:GENARE
Middle Name:C
Last Name:WOOFTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1640 CHARLES PL STE 103
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2868
Mailing Address - Country:US
Mailing Address - Phone:785-776-9461
Mailing Address - Fax:785-776-9946
Practice Address - Street 1:1640 CHARLES PL STE 103
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2868
Practice Address - Country:US
Practice Address - Phone:785-776-9461
Practice Address - Fax:785-776-9946
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2134152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist