Provider Demographics
NPI:1699343756
Name:LENHART, KASEY
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:LENHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11984 OAKRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MI
Mailing Address - Zip Code:48655-9504
Mailing Address - Country:US
Mailing Address - Phone:989-780-3020
Mailing Address - Fax:
Practice Address - Street 1:479 BYPASS 72 NW STE 107
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-1484
Practice Address - Country:US
Practice Address - Phone:864-388-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOPT.2281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist