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Contact Information

LAKE FAMILY VISION CENTER INC
138 SOUTH MAIN
SUITE C
LAURIE, MO65038-1185
 Phone: 573-374-5222
 Fax: 573-374-7351
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for LAKE FAMILY VISION CENTER INC · (Female)

NPI # 1720128713
Status Active
Credentials
Entity Individual
Enumeration date 02/07/2007
Last updated 12/21/2007 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # T02682
  • MO Other 0323200001 CIGNA MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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