Kohm, Traci Lynne

Kohm, Traci Lynne is an individual health care provider with primary practice located at 9549 Watson Road , St. Louis MO 63126. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kohm, Traci Lynne can be contacted via phone (314) 651-3883.

Contact Information

Primary practice address
9549 Watson Road St. Louis MO 63126
Phone: (314) 651-3883
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2006017275 Missouri

Profile Details

NPI number 1053455295
LBN Legal business name Kohm, Traci Lynne
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 19th, 2007
Last updated Nov 27th, 2023 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1053455295 NPPES
Missouri Other MA1595030 MEDICARE ID

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