Organization
NUCROWN, LLC
Active
Other names
Crown Optical
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES D. MATTHEWS (PRESIDENT)
(618) 462-9818
Entity
Organization
Contact information
Practice address
12607 OLIVE BLVD, SAINT LOUIS, MO 63141-6313
(314) 428-0110
(314) 878-7747
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
(800) 432-6004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02999
MO
Other
Enumeration date
02/03/2015
Last updated
04/21/2017
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