| Lake Family Vision Center Inc | |
|
138 South Main, Suite C, Laurie, MO 65038-1185 | |
| (573) 374-5222 | |
| (573) 374-7351 |
| Full Name | Lake Family Vision Center Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 138 South Main, Laurie, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720128713 | NPI | - | NPPES |
| 0323200001 | Other | MO | CIGNA MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | T02682 (Missouri) | Primary |
| 332H00000X | Eyewear Supplier | T02682 (Missouri) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Family Vision Center Inc Po Box 1185, Laurie, MO 65038-1185 Ph: (573) 374-5222 | Lake Family Vision Center Inc 138 South Main, Suite C, Laurie, MO 65038-1185 Ph: (573) 374-5222 |
John A Gazaway, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 138 S. Main, Suite C, Laurie, MO 65038 Phone: 573-374-5222 Fax: 573-374-7351 | |
Devin Coleman, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 130 S Main St, Laurie, MO 65038 Phone: 573-374-5222 | |
Laurie Family Eyecare, Inc. Optometrist Medicare: Medicare Enrolled Practice Location: 138 S. Main, Suite C, Laurie, MO 65037 Phone: 573-374-5222 |