Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2039 | KS |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2039 | KS |
N | 152WP0200X | Pediatric Optomitrist | 2039 | KS |
NPI | 1255781647 |
---|---|
Provider Name | Kevin Tomasu |
First Address | Leawood, KS 66209-3412 |
Second Address | Leawood, KS 66209-3412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2016 |
Last Update Date | 13/10/2020 |