| NPI | 1669756029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JEAN LUCAS Secretary, Owner, O PT Ometrist 636-227-5524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MO TO-3419) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2011-10-04 |