| NPI | 1043280399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA THOMSEN Owner 641-782-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2016-06-13 |