NPI 1124095039 · live from the CMS NPI Registry
Betty J Cantrell, OD
Optometrist in Yates Center, KS. National Provider Identifier 1124095039, active.
NPI record
| NPI | 1124095039 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 218 W Rutledge St, Suite 1, Yates Center, KS 66783 |
| Practice phone | 620-625-3311 |
| Mailing address | 1851 N Webb Rd, Attn Flr2, Wichita, KS 67206 |
| Enumerated | March 1, 2006 |
| Last updated | December 5, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 15243 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.