DR. Russell Wayne Icke, OD
NPI #1134113319 in Wichita, Kansas
Provider Information
- NPI Number
- 1134113319
- Entity Type
- Individual
- Name
- DR. Russell Wayne Icke, OD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Optometrist
- Credential
- OD
- Enumeration Date
- Sep 2, 2005
- Last Updated
- Jul 28, 2010
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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