Goertz, Amy Renee

Goertz, Amy Renee is an individual health care provider with primary practice located at 12111 W Maple St Ste 125 , Wichita KS 67235-8756. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Goertz, Amy Renee can be contacted via phone (316) 832-0088.

Contact Information

Primary practice address
12111 W Maple St Ste 125 Wichita KS 67235-8756
Phone: (316) 832-0088
Fax: (316) 832-0029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1683 Kansas

Profile Details

NPI number 1881680270
LBN Legal business name Goertz, Amy Renee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Aug 9th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881680270 NPPES
Kansas MEDICAID 200277350A

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