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Individual

DR. ELIOT G MASEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
537 W KARSCH BLVD, FARMINGTON, MO 63640-3312
(573) 747-4133
(573) 747-4533
Mailing address
40 E NORTH ST, EUREKA, MO 63025-1205
(636) 200-4393
(636) 938-2650

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010396
IL
152W00000X
Optometrist
Primary
2011037694
MO
152WL0500X
Low Vision Rehabilitation Optometrist
046010396
IL
152WL0500X
Low Vision Rehabilitation Optometrist
2011037694
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046010396
IL
Enumeration date
07/19/2010
Last updated
10/02/2014
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