| NPI | 1053615286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL M BOWERSOX Owner 502-647-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: KY 1301DT) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |