Individual
AMANDA KAY BOSCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 GREEN MOUNT COMMONS DR STE 290, BELLEVILLE, IL 62221-6735
(618) 233-7800
(618) 233-7290
Mailing address
PO BOX 207163, DALLAS, TX 75320-7163
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011272
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2023
Last updated
04/05/2025
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