Organization
NU-CROWN, LLC
Active
Other names
Crown Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES D. MATTHEWS (PRESIDENT)
(618) 462-9818
Entity
Organization
Contact information
Practice address
3732 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63109-1800
(314) 446-1134
(800) 432-6004
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
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24246
SPECTERA
MO
Enumeration date
01/19/2007
Last updated
04/21/2017
Update your record
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