Individual
ASHLEY LYNN DIMERCURIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1259 MAIN ST, IMPERIAL, MO 63052-3852
(636) 461-0470
(636) 461-3016
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2022024656
MO
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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