Basic Information
| Provider Information | |||||||||
| NPI: | 1295752178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENTRETER | ||||||||
| FirstName: | TED | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 975 N MUR LEN RD | ||||||||
| Address2: | SUITE D | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137645995 | ||||||||
| FaxNumber: | 9137646032 | ||||||||
| Practice Location | |||||||||
| Address1: | 975 N MUR LEN RD | ||||||||
| Address2: | SUITE D | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660621861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137645995 | ||||||||
| FaxNumber: | 9137646032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | KS 1126-3 | KS | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.