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General NPI Number Information
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NPI Number | 1770601742
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Entity Type | Organization
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Legal Business Name | LEE ANDREW ST PIERRE
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 2917 BROWNS LN
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City | JONESBORO
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State | AR
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Zip | 72401-7203
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Country | US
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Telephone | 870-802-2020
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Fax | 870-931-7976
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Provider Business Mailing Address
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Address Line | 2917 BROWNS LN
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City | JONESBORO
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State | AR
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Zip | 72401-7203
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Country | US
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Telephone | 870-802-2020
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Fax | 870-931-7976
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEE STPIERRE
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Credential | O.D.
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Telephone | 870-802-2020
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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 | 2459
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License Number State | AR
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