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General NPI Number Information
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NPI Number | 1225255532
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Entity Type | Organization
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Legal Business Name | BROST & STROHMEYER FAMILY EYE CARE PC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 6 COURT SQ
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-1109
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Country | US
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Telephone | 573-783-2251
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Fax | 573-783-5379
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Provider Business Mailing Address
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Address Line | PO BOX 308
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-0308
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Country | US
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Telephone | 573-783-2251
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Fax | 573-783-5379
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYLE E BROST
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Credential | O.D.
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Telephone | 573-783-2251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T02741
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License Number State | MO
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