Individual
CARRIE L. HARTIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2013020890
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528409158
—
MO
05
—
199216722
—
AR
01
—
431560263
TRICARE
MO
01
—
P01222591
RR MCR
MO
Enumeration date
07/11/2013
Last updated
11/20/2013
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