Organization
FREDERICKTOWN VISION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA ANN NEEDHAM (MGR)
(573) 783-3573
Entity
Organization
Contact information
Practice address
152 S MAIN ST, FREDERICKTOWN, MO 63645-1452
(573) 783-5959
(573) 783-5946
Mailing address
152 S MAIN ST, FREDERICKTOWN, MO 63645-1452
(573) 783-5959
(573) 783-5946
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323296400
—
MO
Enumeration date
02/01/2007
Last updated
12/13/2011
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