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General NPI Number Information
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NPI Number | 1477737815
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Entity Type | Organization
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Legal Business Name | T M SWINGER & D V MCKILLIP, PTR
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 214 1ST ST
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City | KENNETT
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State | MO
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Zip | 63857-2053
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Country | US
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Telephone | 573-888-6718
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Fax |
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Provider Business Mailing Address
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Address Line | 214 1ST ST
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City | KENNETT
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State | MO
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Zip | 63857-2053
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Country | US
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Telephone | 573-888-6718
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | VICKIE L HURLEY
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Credential |
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Telephone | 573-333-1860
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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 | T02167
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License Number State | MO
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