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General NPI Number Information
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NPI Number | 1659825065
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Entity Type | Individual
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Provider Name | EMMA BUDRAITIS
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Gender | Female
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 1825 TIN VALLEY CIR STE A
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3248
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Country | US
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Telephone | 205-661-2020
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Fax | 205-856-2036
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Provider Business Mailing Address
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Address Line | 15933 CLAYTON RD STE 201
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City | BALLWIN
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State | MO
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Zip | 63011-2172
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Country | US
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Telephone | 636-200-4393
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Fax | 636-527-0838
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SD67
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License Number State | AL
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