Individual
MR. JOSHUA CLYDE CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
215 SE STATE ROUTE 291, LEES SUMMIT, MO 64063-2939
(816) 246-7779
(816) 246-7780
Mailing address
215 SE STATE ROUTE 291, LEES SUMMIT, MO 64063-2939
(816) 246-7779
(816) 246-7780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1616
KS
152W00000X
Optometrist
Primary
MO2003000960
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33864028
BCBS
MO
Enumeration date
06/05/2006
Last updated
07/01/2008
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