Organization
CLEARWATER VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH DETRING O.D. (PARTNER)
(573) 223-7615
Entity
Organization
Contact information
Practice address
106 S MAIN ST, PIEDMONT, MO 63957-1563
(573) 223-7615
Mailing address
106 S MAIN ST, PIEDMONT, MO 63957-1563
(573) 223-7615
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2426
MO
Other
Enumeration date
01/15/2006
Last updated
02/08/2008
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