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General NPI Number Information
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NPI Number | 1588786750
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Entity Type | Organization
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Legal Business Name | THE LOW VISION CENTER OF ST LOUIS INC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10000 WATSON RD SUITE 2P
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1854
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Country | US
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Telephone | 314-821-1140
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Fax | 314-821-8324
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Provider Business Mailing Address
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Address Line | 10000 WATSON RD SUITE 2P
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1854
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Country | US
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Telephone | 314-821-1140
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Fax | 314-821-8324
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Authorized Official
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Title or Position | OWNER
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Name | MS. RITA JOAN KNOX
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Credential |
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Telephone | 314-821-1140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | TO 2005
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License Number State | MO
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