| NPI | 1003263096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA NATHAN ETTINGER Optometrist 314-420-7031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MO T02543) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-06-01 |