Organization
OFALLON OPTOMETRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN M SHULMAN O.D. (OPTOMETRIST)
(636) 272-3383
Entity
Organization
Contact information
Practice address
409 S MAIN ST, O FALLON, MO 63366-2532
(636) 272-3383
(636) 272-3381
Mailing address
409 S MAIN ST, O FALLON, MO 63366-2532
(636) 272-3383
(636) 272-3381
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02240
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310754213
—
MO
Enumeration date
02/27/2007
Last updated
04/23/2014
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