| NPI | 1013012327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA RENAE HEIL Owner 701-333-8243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ND 530) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2022-09-09 |