| NPI | 1902000466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA J. STILLEY O.D./Secretary 417-553-9903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2002015335) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2017-10-20 |