| NPI | 1346419645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D PECKHAM Doctor Owner Optometrist 636-927-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO TO2158) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2008-03-05 |