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General NPI Number Information
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NPI Number | 1316072986
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Entity Type | Organization
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Legal Business Name | PRANGE RILEY OPTOMETRISTS, P.C.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 280 E SPRINGFIELD RD
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City | SULLIVAN
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State | MO
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Zip | 63080-1364
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Country | US
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Telephone | 573-468-4032
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Fax | 573-468-2935
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Provider Business Mailing Address
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Address Line | 280 E SPRINGFIELD RD
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City | SULLIVAN
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State | MO
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Zip | 63080-1364
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Country | US
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Telephone | 573-468-4032
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Fax | 573-468-2935
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Authorized Official
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Title or Position | PRESIDENT-OWNER
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Name | JASON T RILEY
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Credential | OD
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Telephone | 573-468-4032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TO2592
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License Number State | MO
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