Wakan Path, LLC

NPI #1730660580 in Omaha, Nebraska

Provider Information

NPI Number: 1730660580
Entity Type: Organization
Organization Name: Wakan Path, LLC
Primary Specialty: Optometrist
Enumeration Date: Aug 28, 2018
Last Updated: Nov 13, 2018

Practice Location

Address: 5018 AMES AVE
City: Omaha
State: Nebraska
ZIP Code: 68104-2323
Phone: (402) 970-9301

Authorized Official

Name: DR. LYNDON GRAVES, DO
Title: PRESIDENT
Phone: (402) 210-6129

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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