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Individual

MS. AMANDA J KIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
430 NEAL ST, COOKEVILLE, TN 38501-0916
(931) 528-6411
(931) 372-0380
Mailing address
430 NEAL ST, COOKEVILLE, TN 38501-0916
(931) 528-6411
(931) 372-0380

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2944
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301195
BC-BS
TN
Enumeration date
09/08/2010
Last updated
10/11/2023
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