Provider Demographics
NPI:1821636309
Name:TONGANOXIE EYE CARE LLC
Entity Type:Organization
Organization Name:TONGANOXIE EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VOLK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:913-845-2030
Mailing Address - Street 1:103 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-9770
Mailing Address - Country:US
Mailing Address - Phone:913-845-2030
Mailing Address - Fax:913-845-9444
Practice Address - Street 1:103 W 4TH ST
Practice Address - Street 2:
Practice Address - City:TONGANOXIE
Practice Address - State:KS
Practice Address - Zip Code:66086-9770
Practice Address - Country:US
Practice Address - Phone:913-845-2030
Practice Address - Fax:913-845-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty