Individual
JOHN L COTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3700 SW CHEDDINGTON DR, LEES SUMMIT, MO 64082-4797
(816) 623-9990
(816) 623-9449
Mailing address
3700 SW CHEDDINGTON DR, LEES SUMMIT, MO 64082-4797
(816) 623-9990
(816) 623-9990
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1680
KS
152W00000X
Optometrist
Primary
2004016908
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396743472
—
MO
Enumeration date
07/12/2005
Last updated
07/08/2019
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