Divine, Kylie Marie
Divine, Kylie Marie is an individual health care provider with primary practice located at 1347 North Westwood Blvd. , Poplar Bluff MO 63901. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Divine, Kylie Marie can be contacted via phone (573) 712-2333.Contact Information
Primary practice address
1347 North Westwood Blvd.
Poplar Bluff MO 63901
Phone: (573) 712-2333
Fax: (573) 712-2433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2010020558 | Missouri |
Profile Details
| NPI number | 1558672162 |
|---|---|
| LBN Legal business name | Divine, Kylie Marie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2010 |
| Last updated | Jan 27th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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