NPI | 1063928554 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL FRICKE Assistant Secretary 844-377-6468 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology |
Additional Taxonomies | 152W00000X Optometrist |
Enumeration Date | 2017-12-19 |
Last Update Date | 2017-12-19 |