Grene Vision Group LLC

NPI #1417169780 in Derby, Kansas

Provider Information

NPI Number: 1417169780
Entity Type: Organization
Organization Name: Grene Vision Group LLC
Primary Specialty: Optometrist
Enumeration Date: May 7, 2007
Last Updated: Feb 20, 2008

Practice Location

Address: 620 N BALTIMORE AVE
City: Derby
State: Kansas
ZIP Code: 67037
Phone: (316) 789-8383

Authorized Official

Name: SHERYL DAVENPORT
Title: INSURANCE DEPARTMENT SUPERVISOR
Phone: (316) 858-3831

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X
Optometrist	152W00000X	Primary

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