Individual
DR. ANGEL KEITH RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1310 PREACHER ROE BLVD # HGW, WEST PLAINS, MO 65775-2938
(787) 510-5403
Mailing address
PO BOX 1701, WEST PLAINS, MO 65775-7001
(787) 510-5403
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2011037045
MO
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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