| NPI | 1356161509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES W PELTON Optometrist 636-586-5406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-14 |