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Individual

DR. LISA CHABOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D

Contact information

Practice address
248 S FLORISSANT RD, FERGUSON, MO 63135-2736
(314) 522-8773
(314) 522-0228
Mailing address
248 S FLORISSANT RD, FERGUSON, MO 63135-2737

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03129
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
181457
BLUE CROSS BLUE SHIELD
MO
05
316777663
MO
Enumeration date
12/12/2006
Last updated
04/20/2015
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