Individual
MR. RICHARD LANE NUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1111 E CAMBRIDGE ST, BOLIVAR, MO 65613-3500
(417) 326-6001
Mailing address
1111 E CAMBRIDGE ST, BOLIVAR, MO 65613-3500
(417) 326-6001
(417) 326-6002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02491
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710964309
—
MO
Enumeration date
12/27/2005
Last updated
10/26/2020
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