| NPI | 1104953660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM SCIORTINO Ophthalmologist 314-352-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: MO MDR4D74) |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2011-10-27 |