Organization
NUCROWN, LLC
Active
Other names
Crown Optical
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES D. MATTHEWS (PRESIDENT)
(618) 462-9818
Entity
Organization
Contact information
Practice address
10867 W FLORISSANT AVE, SAINT LOUIS, MO 63136-2405
(314) 817-5367
(314) 741-4947
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
(314) 741-4947
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2999
MO
Other
Enumeration date
03/13/2012
Last updated
04/21/2017
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