Provider Demographics
NPI:1245677236
Name:MORRISON OPTOMETRIC ASSOCIATES, PA
Entity type:Organization
Organization Name:MORRISON OPTOMETRIC ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-462-8231
Mailing Address - Street 1:1005 S RANGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-3537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:707 GRANT ST
Practice Address - Street 2:
Practice Address - City:ATWOOD
Practice Address - State:KS
Practice Address - Zip Code:67730-1526
Practice Address - Country:US
Practice Address - Phone:785-462-8231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORRISON OPTOMETRIC ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1897152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty