Individual
KELLY GANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.
Contact information
Practice address
900 N US HIGHWAY 67, FLORISSANT, MO 63031-2919
(314) 838-0321
Mailing address
900 N US HIGHWAY 67, FLORISSANT, MO 63031-2919
(314) 838-0321
Taxonomy
Speciality
Code
Description
License number
State
156FX1101X
Ophthalmic Assistant
Primary
—
—
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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