| NPI | 1932227485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH L SWALLOW President CEO 314-821-4252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MO 103873) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO T03150) |
| 174400000X Specialist (Licence: MO R9F62) | |
| 174400000X Specialist (Licence: MO R9A10) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2009-09-17 |