| NPI | 1023528619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LE President 708-275-6192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| 213E00000X Podiatrist | |
| 231H00000X Audiologist | |
| 237600000X Audiologist-Hearing Aid Fitter | |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2017-10-09 |