Grene Vision Group LLC

NPI #1891907622 in Fredonia, Kansas

Provider Information

NPI Number: 1891907622
Entity Type: Organization
Organization Name: Grene Vision Group LLC
Primary Specialty: Optometrist
Enumeration Date: May 4, 2007
Last Updated: Feb 20, 2008

Practice Location

Address: 1508 MADISON
City: Fredonia
State: Kansas
ZIP Code: 66736
Phone: (620) 378-3761

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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