Individual
DR. KEVIN JACOB DITTLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7840 NATURAL BRIDGE BLVD, PATIENT CARE CENTER, SAINT LOUIS, MO 63121
(314) 516-5131
(314) 516-5507
Mailing address
1 UNIVERSITY BLVD, PATIENT CARE CENTER, ST LOUIS, MO 63121
(314) 516-5131
(314) 516-5507
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2018021087
MO
152WP0200X
Pediatric Optometrist
2018021087
MO
Other
Enumeration date
06/20/2018
Last updated
02/27/2019
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