| NPI | 1124684923 |
|---|---|
| Other Name | IVORY A. KINSLOW, MDPA MAG |
| Entity Type | Organization |
| Authorized Contact | SHARON L WINN CEO 573-718-4808 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |