NPI | 1003935487 |
---|---|
Entity Type | Organization |
Authorized Contact | STACEY LYN WILDA President Owner Optometrist 580-336-0777 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2236) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2008-12-08 |