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General NPI Number Information
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NPI Number | 1811259518
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Entity Type | Individual
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Provider Name | ASHLEY A. THILL O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2012
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 3231 S NATIONAL AVE SUITE 165/166
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City | SPRINGFIELD
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State | MO
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Zip | 65807-7304
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Country | US
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Telephone | 417-820-9393
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Fax | 417-841-0181
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Provider Business Mailing Address
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Address Line | PO BOX 505164
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City | SAINT LOUIS
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State | MO
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Zip | 63150-5164
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Country | US
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Telephone | 417-820-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2755
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2013013533
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License Number State | MO
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