Individual
KYLIE MARIE DIVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
1475 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3315
(573) 712-2333
(572) 712-2433
Mailing address
1475 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3315
(573) 712-2333
(573) 712-2433
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2010020558
MO
Other
Enumeration date
06/29/2010
Last updated
02/05/2026
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