NPI 1053455295

Traci Lynne Kohm, OD

Practitioner Optometrist St. Louis, MO

Practice location

Address: 9549 Watson Road, St. Louis, MO 63126
Phone: (314) 651-3883

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2006017275 (MO)

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Registry record

NPI: 1053455295
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Feb 2007
Record last updated: 27 Nov 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.