Individual
WILLIAM J ODNEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
466 MARKET ST, STE GENEVIEVE, MO 63670-1520
(573) 883-2774
(573) 883-9087
Mailing address
466 MARKET ST, STE GENEVIEVE, MO 63670-1520
(573) 883-2774
(573) 883-9087
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2366
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108009
OPTOMETRY
MO
05
—
310040316
—
MO
Enumeration date
11/06/2006
Last updated
04/08/2015
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