Provider Demographics
NPI:1811003874
Name:PERRINE, DANIEL RAY JR (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RAY
Last Name:PERRINE
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:8656 OLD TOWNE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3908
Mailing Address - Country:US
Mailing Address - Phone:614-284-1798
Mailing Address - Fax:
Practice Address - Street 1:10950 NEW HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-4435
Practice Address - Country:US
Practice Address - Phone:314-388-9999
Practice Address - Fax:314-388-9990
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008028014152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist