| NPI | 1588763189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN PAINTER Credentialing Supervisor 314-989-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-07-28 |