| NPI | 1770879496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY L PLANK Owner/O PT Ician 314-367-1848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-06-21 |