| NPI | 1982839262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY LYNN MIANA COO 314-726-5669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2023-09-18 |