NPI | 1376958843 |
---|---|
Entity Type | Organization |
Authorized Contact | STELLA ONYEKWELU Dr 618-741-3715 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002814) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: GA OPT002814) |
152WP0200X Optometrist, Pediatrics (Licence: GA OPT002814) | |
Enumeration Date | 2014-06-24 |
Last Update Date | 2014-06-24 |