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 |