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Individual

JOSEPH A. STROETKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
280 E SPRINGFIELD RD, SULLIVAN, MO 63080-1364
(573) 468-4032
Mailing address
PO BOX 457, SULLIVAN, MO 63080-0457
(573) 468-4032

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02592
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0204770001
MEDICARE NSC #
MO
05
312334105
MO
Enumeration date
06/27/2006
Last updated
06/24/2008
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