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 |