Wade Godshall OD

NPI 1013072867 - Optometrist - 152W00000X

NPI Details
NPI 1013072867
Gender Male
Enumeration Date 12/22/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1008 INDEPENDENCE CENTER DRIVE
INDEPENDENCE MO, 64057, US
Phone (816) 795-0011
Fax (816) 795-8267
Business Location
11103 WEST AVE
SUITE 6
SAN ANTONIO TX, 78213-1370, US
Phone (210) 524-6663
Fax (210) 524-6587
Toxanomy
Taxonomy Code 152W00000X
License State Missouri
License Number T03377
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According to our database, Wade Godshall OD NPI is 1013072867, taxonomy code is 152W00000X and license number is T03377, license state is located at Missouri. Wade Godshall OD physically located at 1008 Independence Center Drive, Independence MO, 64057. NPI Number Wade Godshall OD has the Individual type.

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1013072867 NPI number is provided on an as is basis without warranty of any kind. 1013072867 is maintained by the National Plan & Provider Enumeration System. The contents of Wade Godshall OD are for informational purposes only.