| |
1910 First Capital Drive, St. Charles, MO 63301 | |
(314) 741-8183 | |
(314) 741-4947 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 1910 First Capital Drive, St. Charles, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114337102 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Missouri) | Primary |
Mailing Address | Practice Location Address |
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211 E Broadway, Alton, IL 62002-6220 Ph: (618) 462-9818 | 1910 First Capital Drive, St. Charles, MO 63301 Ph: (314) 741-8183 |