Healthcare Provider Details

I. General information

NPI: 1093032773
Provider Name (Legal Business Name): GELNER OPTOMETRY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14386 WOODLAKE DR
CHESTERFIELD MO
63017-5714
US

IV. Provider business mailing address

14386 WOODLAKE DR
CHESTERFIELD MO
63017-5714
US

V. Phone/Fax

Practice location:
  • Phone: 314-434-2626
  • Fax: 314-434-2631
Mailing address:
  • Phone: 314-434-2626
  • Fax: 314-434-2631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA VIRTUE GELNER
Title or Position: PRESIDENT
Credential: O.D.
Phone: 314-434-2626