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Organization

NORMAN PROFESSIONAL EYECARE AND CONTACT LENS CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN NORMAN OD (OWNER/PRESIDENT)
(573) 803-2211
Entity
Organization

Contact information

Practice address
21 DOCTORS PARK, SUITE B, CAPE GIRARDEAU, MO 63703-4927
(573) 803-2211
Mailing address
21 DOCTORS PARK, SUITE B, CAPE GIRARDEAU, MO 63703-4927
(573) 803-2211

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03491
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1235493164
NPI
Enumeration date
06/26/2012
Last updated
12/17/2012
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