Individual
CORY MYREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
849 STONERIDGE PKWY, JEFFERSON CITY, MO 65109
(573) 694-2805
Mailing address
4234 CLINE RD APT C, FORT CAMPBELL, KY 42223-1945
(573) 694-2805
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2018019010
MO
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730537630
NPI
—
Enumeration date
06/01/2016
Last updated
06/28/2023
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