| NPI | 1104953660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH DEBORAH KUTZ Billing & Credential Manager 314-352-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center Ophthalmologic Surgery |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2025-06-10 |