NPI | 1003995044 |
---|---|
Entity Type | Organization |
Authorized Contact | DARAN M DECALESTA President 541-343-3333 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2022-06-28 |