| NPI | 1053495457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA JOAN STEVENS President 307-634-3452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WY WY212T) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: WY WY212T) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: WY WY212T) | |
| 152WP0200X Optometrist Pediatrics (Licence: WY WY212T) | |
| 152WS0006X Optometrist Sports Vision (Licence: WY WY212T) | |
| 152WV0400X Optometrist Vision Therapy (Licence: WY WY212T) | |
| 152WX0102X Optometrist Occupational Vision (Licence: WY WY212T) | |
| 156F00000X Technician/Technologist | |
| 156FC0800X Technician/Technologist Contact Lens | |
| 156FC0801X Technician/Technologist Contact Lens Fitter | |
| 156FX1201X Technician/Technologist Optometric Assistant | |
| 156FX1202X Technician/Technologist Optometric Technician | |
| 156FX1800X Technician/Technologist Optician | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |