Otis Optometry, LLC

NPI #1568873602 in Camdenton, Missouri

Provider Information

NPI Number: 1568873602
Entity Type: Organization
Organization Name: Otis Optometry, LLC
Primary Specialty: Optometrist
Enumeration Date: May 12, 2014
Last Updated: Jul 29, 2014

Practice Location

Address: 94 CECIL ST
City: Camdenton
State: Missouri
ZIP Code: 65020-7057
Phone: (573) 317-9279

Authorized Official

Name: MR. MATT DAVID WICKHAM, O.D.
Title: OWNER
Phone: (314) 276-1228

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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