DR. Logan Kale Banister, O.D.

NPI #1154551828 in Derby, Kansas

Provider Information

NPI Number: 1154551828
Entity Type: Individual
Name: DR. Logan Kale Banister, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Jul 16, 2009
Last Updated: Aug 28, 2009

Practice Location

Address: 1626 E MADISON AVE
City: Derby
State: Kansas
ZIP Code: 67037-2076
Phone: (316) 788-1535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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