| 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 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-06-28 |