| NPI | 1033428768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY H FISHMAN Owner 502-451-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2020-04-22 |