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Individual

DETLEF SLEICHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1229 E SEMINOLE ST STE 430, SPRINGFIELD, MO 65804-2227
(417) 820-9393
Mailing address
1229 E SEMINOLE ST STE 430, SPRINGFIELD, MO 65804-2227
(417) 820-9393

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
091373
IA
152W00000X
Optometrist
Primary
2022005213
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1469
STATE LICENSE NUMBER
NE
01
648
THERAPEUTIC CERTIFICATION
NE
Enumeration date
06/27/2017
Last updated
03/28/2022
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