| NPI | 1992171201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE ROBERTSON MCELVAINE Practice Owner 417-300-4587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2011018573) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2024-05-08 |