Individual
DR. ROBERT ELLIS VANGILDER JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1661 JUNGERMANN RD, SAINT PETERS, MO 63304-2821
(636) 447-9772
(636) 447-6476
Mailing address
1661 JUNGERMANN RD, SAINT PETERS, MO 63304-2821
(636) 447-9772
(636) 447-6476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02318
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T02318
LICENSE NUMBER
MO
Enumeration date
07/07/2005
Last updated
07/08/2007
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