| NPI | 1639292527 |
|---|---|
| Doing Business As | MARYVILLE EYE CLINIC |
| Entity Type | Organization |
| Authorized Contact | SUDARSAN CHAVALA Ophthalmologist 660-562-2566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO R8855) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MO R8855) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2008-06-30 |