Kohm, Traci Lynne
Kohm, Traci Lynne is an individual health care provider with primary practice located at 9549 Watson Road , St. Louis MO 63126. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kohm, Traci Lynne can be contacted via phone (314) 651-3883.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2006017275 | Missouri |
Profile Details
| NPI number | 1053455295 |
|---|---|
| LBN Legal business name | Kohm, Traci Lynne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 19th, 2007 |
| Last updated | Nov 27th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053455295 | NPPES |
| Missouri | Other | MA1595030 | MEDICARE ID |
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