Provider Demographics
NPI:1831777911
Name:RADCLIFF FAMILY EYECARE, LLC
Entity type:Organization
Organization Name:RADCLIFF FAMILY EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHIANNON
Authorized Official - Middle Name:SHAE
Authorized Official - Last Name:RADCLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-528-1091
Mailing Address - Street 1:2136 N KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67901-2012
Mailing Address - Country:US
Mailing Address - Phone:620-624-3841
Mailing Address - Fax:620-624-0241
Practice Address - Street 1:2136 N KANSAS AVE
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2012
Practice Address - Country:US
Practice Address - Phone:620-624-3841
Practice Address - Fax:620-624-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty