Individual
AMANDA EDMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3821 VETERANS MEMORIAL PKWY, SAINT PETERS, MO 63376-6416
(636) 928-1111
Mailing address
9979 WINGHAVEN BLVD STE 210, O FALLON, MO 63368-3628
(636) 695-8555
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2023022826
MO
Other
Enumeration date
06/27/2023
Last updated
02/21/2025
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