| NPI | 1023247087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTAL H JACQUES Managing Member 314-249-7446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2009016926) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2010-08-20 |