Kathleen Gore Avery, O.D. Valid NPI

Individual provider · Optometrist · O Fallon, MO

NPI

1417085820

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

TO2659 (MO)

Sex

Female

Sole proprietor

Yes

Enumerated

2007-02-28

Last updated

2019-10-14