Wolber, Kent Randall

Wolber, Kent Randall is an individual health care provider with primary practice located at 175 Shinn Ln , Hannibal MO 63401-6754. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wolber, Kent Randall can be contacted via phone (573) 406-5730.

Contact Information

Primary practice address
175 Shinn Ln Hannibal MO 63401-6754
Fax: (573) 406-1369
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T02786 Missouri

Profile Details

NPI number 1104883560
LBN Legal business name Wolber, Kent Randall
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated Apr 23rd, 2018 - about 6 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 1104883560 NPPES
Missouri MEDICAID 312852700

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