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General NPI Number Information
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NPI Number | 1376517417
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Entity Type | Organization
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Legal Business Name | CHIPPEWA EYE CENTRE, INC.
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 6756 CHIPPEWA ST
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2542
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Country | US
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Telephone | 314-351-4991
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Fax |
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Provider Business Mailing Address
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Address Line | 6756 CHIPPEWA ST
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2542
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Country | US
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Telephone | 314-351-4991
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL MICHAEL BERNIER
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Credential | O.D.
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Telephone | 314-351-4991
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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 |
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License Number State |
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