| NPI | 1033236310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SLADE LINDQUIST President 402-697-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WS0006X Optometrist, Sports Vision (Licence: NE NE 1164) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2010-09-03 |