NPI 1003263096

Ettinger Optometry, LLC

Organisation Corneal and Contact Management Optometrist Fort Leonard Wood, MO

Practice location

Address: 143 Replacement Ave Building 487, Fort Leonard Wood, MO 65473-9092
Phone: (573) 329-4860
Fax: (573) 329-4860

Authorised official

Name: Ira Nathan Ettinger
Title: Optometrist
Phone: (314) 420-7031

Registered specialties

Corneal and Contact Management Optometrist Primary

Eye and Vision Services Providers Taxonomy 152WC0802X Licence T02543 (MO)

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Registry record

NPI: 1003263096
Entity type: Organization
NPI issued: 19 May 2016
Record last updated: 1 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.