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General NPI Number Information
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NPI Number | 1629106620
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Entity Type | Organization
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Legal Business Name | THE KOETTING ASSOCIATES INC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 2511 S BRENTWOOD BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63144-2308
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Country | US
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Telephone | 314-863-0000
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Fax | 314-961-1041
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Provider Business Mailing Address
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Address Line | 2511 S BRENTWOOD BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63144-2308
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Country | US
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Telephone | 314-863-0000
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Fax | 314-961-1041
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARMEN F CASTELLANO
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Credential | O.D.
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Telephone | 314-863-0000
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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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