| NPI | 1457763658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY JOANNE KNICKERBOCKER Optometrist 573-406-5276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2000143624) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2014-05-22 |