Provider First Line Business Practice Location Address:
1 BARNES JEWISH HOSPITAL PLAZA
Provider Second Line Business Practice Location Address:
90-23-402 VISION CENTER
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63110-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-362-6123
Provider Business Practice Location Address Fax Number:
314-747-3726
Provider Enumeration Date:
01/30/2007