Organization
AMY J. KNICKERBOCKER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY JOANNE KNICKERBOCKER O.D. (OPTOMETRIST)
(573) 406-5276
Entity
Organization
Contact information
Practice address
7 OAK RIDGE POND RD, HANNIBAL, MO 63401-6539
(573) 406-5276
(573) 406-1503
Mailing address
3650 STARDUST DR, HANNIBAL, MO 63401-2480
(573) 406-1503
(573) 406-1057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2000143624
MO
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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