Individual
KIMBERLY EVERINGHAM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
700 W KENT AVE, MISSOULA, MT 59801-6772
(406) 541-3804
(406) 541-1810
Mailing address
PO BOX 4907, 700 WEST KENT, MISSOULA, MT 59806-4907
(406) 541-3804
(406) 541-1810
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
542
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
482469
—
MT
05
—
80722200
—
ID
Enumeration date
09/13/2005
Last updated
07/08/2007
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