Organization Name: | ADAM KETTELER, O.D. |
NPI Number: | 1710123781 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ADAM J KETTELER (OPTOMETRIST/OWNER) |
Mailing Address: | 313 W Pearl St Atkinson |
State: | NE US |
Postal Code: | 687134958 |
Phone Number: | 4029252669 |
Fax Number: | 4029252306 |
NPI Enumeration Date: | 12/22/2008 |
NPI Last Update Date: | 12/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 1218 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |