| |
621 S New Ballas Rd, Suite 7a, Saint Louis, MO 63141-8232 | |
(314) 251-6430 | |
(314) 251-6065 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 621 S New Ballas Rd, Saint Louis, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992881973 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
621 S New Ballas Rd, Suite 7a, Saint Louis, MO 63141-8232 Ph: (314) 251-6430 | 621 S New Ballas Rd, Suite 7a, Saint Louis, MO 63141-8232 Ph: (314) 251-6430 |