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Individual

MICHAEL HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
745 N NEW BALLAS RD, SAINT LOUIS, MO 63141-6715
(314) 567-7423
(314) 567-7562
Mailing address
745 N NEW BALLAS RD, SAINT LOUIS, MO 63141-6715
(314) 567-7423
(314) 567-7562

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
18045537
MO

Other

Enumeration date
04/06/2007
Last updated
04/30/2008
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