Individual
KEVIN FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12490 TESSON FERRY RD, SAINT LOUIS, MO 63128-2702
(314) 849-6700
(314) 849-6706
Mailing address
12490 TESSON FERRY RD, SAINT LOUIS, MO 63128-2702
(314) 849-6700
(314) 849-6706
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2015021244
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015021244
HEARING AID DISPENSER LICENSE
MO
Enumeration date
09/29/2015
Last updated
09/29/2015
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