Individual
DR. KENT RANDALL WOLBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
175 SHINN LN, HANNIBAL, MO 63401-6754
(573) 406-5730
(573) 406-1369
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02786
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312852700
—
MO
Enumeration date
04/28/2006
Last updated
04/23/2018
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