Organization Name: | RETINA ASSOCIATES OF ST LOUIS, INC |
NPI Number: | 1750581666 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHERRIE KLEEKAMP (OFFICE ADMINISTRATOR) |
Mailing Address: | 1224 Graham Rd Suite 3011 Florissant |
State: | MO US |
Postal Code: | 630318028 |
Phone Number: | 3148931211 |
Fax Number: | 3148398429 |
NPI Enumeration Date: | 07/19/2007 |
NPI Last Update Date: | 10/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |