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Individual

GARY WILBUR VICKERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3301 MOUNT SHASTA WAY, LOUISVILLE, KY 40241-6213
(502) 425-5839
Mailing address
3301 MOUNT SHASTA WAY, LOUISVILLE, KY 40241-6213
(502) 425-5839

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
775DT
KY

Other

Enumeration date
01/14/2006
Last updated
04/23/2011
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