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Organization

RIVERA OPTOMETRIC GROUP P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGEL KEITH RIVERA O.D. (PRESIDENT)
(417) 204-2320
Entity
Organization

Contact information

Practice address
1310 PREACHER ROE BLVD # HGW, WEST PLAINS, MO 65775-2938
(417) 257-2807
(417) 257-2815
Mailing address
PO BOX 1701, WEST PLAINS, MO 65775-7001
(417) 204-2320

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2011037045
MO

Other

Enumeration date
04/10/2012
Last updated
04/10/2012
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