| NPI | 1275539173 |
|---|---|
| Former Legal Business Name | CLINICAL OPHTHALMOLOGY, INC. |
| Entity Type | Organization |
| Authorized Contact | LISA JEAN TYCHSEN Office Manager 314-395-9613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2019-12-24 |