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DR. CORTNEY MARIE FOGARTY O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1629451935

Individual Registrant:
DR. CORTNEY MARIE FOGARTY O.D.
Gender: F
Not Sole Proprietor

Location and contact information for practice:
10101 GRAVOIS RD  AFFTON, MO 63123-4025 US
Tel: 314-282-9050  Fax: --

Contact information for business:
10101 GRAVOIS RD  AFFTON, MO 63123-4025 US
Tel: 314-282-9050  Fax: --

Registration Information:
NPI: 1629451935
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
MO2015021539

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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