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Organization

PEC SOUTH COUNTY LLC

Active
Other names
Performance Eyecare
Organization subpart
No

Provider details

NPI number
Authorized official
DIRK MASSIE OD (OPTOMETRIST/OWNER)
(618) 234-3053
Entity
Organization

Contact information

Practice address
4412 TELEGRAPH RD, SAINT LOUIS, MO 63129-3316
(618) 234-3053
Mailing address
4111 N ILLINOIS ST, SWANSEA, IL 62226-7609
(618) 234-3053

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary

Other

Enumeration date
11/18/2019
Last updated
11/18/2019
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