Crutchfield, Kenneth Graham
Crutchfield, Kenneth Graham is an sole proprietor health care provider with primary practice located at 310 Kent St , Jefferson City MO 65109-6107. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Crutchfield, Kenneth Graham can be contacted via phone (573) 659-7363.Contact Information
Primary practice address
310 Kent St
Jefferson City MO 65109-6107
Phone: (573) 659-7363
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | T02684 | Missouri |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0601001489 | Virginia |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 04962T | Texas |
Profile Details
| NPI number | 1093916223 |
|---|---|
| LBN Legal business name | Crutchfield, Kenneth Graham |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 28th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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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