| NPI | 1548654981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M GOLDBERG Owner 314-629-7667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO MOT02606) |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2016-06-16 |