| NPI | 1063117455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIS DENNIS GRAJALES O PT Ometrist 484-288-0315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-12-15 |