Eyecare Of Boonville, LLC
Optometrist in Boonville, MO. Organization (NPI-2).
NPI number1669664280
StatusActive
Last updated in NPPESSep 9, 2008
Details
- NPI
- 1669664280
- Entity type
- Organization (NPI-2)
- Legal business name
- Eyecare Of Boonville, LLC
- Organization subpart
- No
- Enumeration date
- Aug 16, 2007
- Last updated
- Sep 9, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2004017361 | MO | Yes |
Practice location
505 E Walnut StBoonville, MO 65233-1665
Phone 660-882-2444
Mailing address
505 E Walnut StBoonville, MO 65233-1665
Phone 660-882-2444
Authorized official
Jeff D. Birdsong
Manager
6608822444
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