| NPI | 1396781829 |
|---|---|
| Former Legal Business Name | 20/20 OPTICAL |
| Entity Type | Organization |
| Authorized Contact | SAMEENA SULTANA KHAN Optometist/Office Manager 636-825-2625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO TO3449) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2009-12-01 |