| NPI | 1245411776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE WILLIAM ERNST Owner 636-456-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: MO T02923) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO T02923) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2008-03-27 |