Individual
DR. JUSTIN LEE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
612 E ELM ST, REPUBLIC, MO 65738-1552
(417) 732-5575
Mailing address
102 W LOYAL LN, CLEVER, MO 65631-9113
(417) 583-2138
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2006018212
MO
Other
Enumeration date
07/18/2006
Last updated
03/17/2010
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