Individual
QUINN GALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
84 PROFESSIONAL PKWY, TROY, MO 63379-2822
(901) 832-4090
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046.011449
IL
152W00000X
Optometrist
Primary
2020015615
MO
152WX0102X
Occupational Vision Optometrist
2020015615
MO
Other
Enumeration date
06/28/2020
Last updated
06/10/2022
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