| NPI | 1003932088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE CONGDON Treasurer 715-732-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2019-08-26 |