Organization
DR. MICHAEL R. PENNEY OPTOMETRIST PC
Active
Parent organization
DR. MICHAEL R PENNEY OPTOMETRIST PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DR. MICHAEL R PENNEY OPTOMETRIST PC
Authorized official
DR. MICHAEL R. PENNEY O.D. (OWNER)
(573) 785-1442
Entity
Organization
Contact information
Practice address
3061 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-8658
(573) 785-1442
(573) 776-6024
Mailing address
3061 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-8658
(573) 785-1442
(573) 776-6024
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02754
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312422207
—
MO
Enumeration date
06/06/2007
Last updated
03/10/2014
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