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1851916035
NICHOLAS PORTELL
SAINT CHARLES, MO
NPI
1851916035
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: MO 2020015799)
Enumeration Date
2020-06-12
Last Update Date
2021-04-26
Business Address
NICHOLAS PORTELL OD
2121 ZUMBEHL RD
SAINT CHARLES, MO 63303-2724
Phone number: 636-949-2906
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Mailing Address
NICHOLAS PORTELL OD
PO BOX 207158
DALLAS, TX 75320-7158
Phone number: 636-200-4393
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