Christopher J Derose O.D.

NPI 1831141753 - Optometrist - 152W00000X

NPI Details
NPI 1831141753
Gender Male
Enumeration Date 05/17/2006
Last Updated 04/10/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
500 KEENE ST
SUITE 103
COLUMBIA MO, 65201-8104, US
Phone (573) 874-2030
Fax (573) 884-5575
Business Location
500 KEENE ST
SUITE 103
COLUMBIA MO, 65201-8104, US
Phone (573) 874-2030
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Illinois
License Number 046009246
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According to our database, Dr. Christopher J Derose O.D. NPI is 1831141753, taxonomy code is 152W00000X and license number is 046009246, license state is located at Illinois. Christopher J Derose O.D. physically located at 500 Keene St, Columbia MO, 65201-8104. NPI Number Christopher J Derose O.D. has the Individual type.

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1831141753 NPI number is provided on an as is basis without warranty of any kind. 1831141753 is maintained by the National Plan & Provider Enumeration System. The contents of Christopher J Derose O.D. are for informational purposes only.