| NPI | 1295913283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY D. KING Sole Proprietor 573-392-7126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-02-01 |