| NPI | 1487104600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WRAY BRUCE COOK Owner/Ocularist 314-567-7585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MO 156FX1700X) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |