| NPI | 1154698702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDWARD BRUCE O PT Ometrist 636-227-8591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO TO3376) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |