Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1101X | Ophthalmic Assistant |
NPI | 1306005855 |
---|---|
Provider Name | Mr. James Joseph Rooney |
First Address | Saint Louis, MO 63141-8232 |
Second Address | Saint Louis, MO 63141-8232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 09/06/2008 |