NPI | 1790978575 |
---|---|
Entity Type | Organization |
Authorized Contact | MEDRO JOSEPH BRODEUR Optometrist 573-437-8004 |
Organization Subpart ? | No |
Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MO TO2435) |
Enumeration Date | 2007-08-24 |
Last Update Date | 2013-02-21 |