Organization
SUREVISION EYE CENTERS MIDWEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY LYNN MIANA COE (COO)
(314) 726-5669
Entity
Organization
Contact information
Practice address
320 BROOKES DR STE 111, HAZELWOOD, MO 63042-2735
(314) 726-5669
(314) 726-5109
Mailing address
320 BROOKES DR, STE 111, HAZELWOOD, MO 63042-2736
(314) 726-5669
(314) 726-5109
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/15/2009
Last updated
09/18/2023
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