Organization
NU-CROWN, LLC
Active
Other names
Crown Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES MATTHEWS (PRESIDENT)
(618) 462-9818
Entity
Organization
Contact information
Practice address
9924 KENNERLY ROAD, SAINT LOUIS, MO 63128
(314) 842-5858
(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
—
14073
SPECTERA
MO
Enumeration date
12/04/2006
Last updated
04/21/2017
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