Individual
DR. VINCENT HARLON COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
812B N ONE MILE RD, DEXTER, MO 63841-1034
(573) 624-8829
(573) 624-3636
Mailing address
812B N ONE MILE RD, PO BOX 534, DEXTER, MO 63841-1034
(573) 624-8829
(573) 624-3636
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2520
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311660906
—
MO
Enumeration date
02/27/2007
Last updated
09/07/2011
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