| NPI | 1619576808 |
|---|---|
| Doing Business As | SHAWNEE OPTICAL |
| Entity Type | Organization |
| Authorized Contact | CATHY L SHORT Credentialing Manager 618-462-9818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |