| NPI | 1073505814 |
|---|---|
| Other Name | NEURO VISUAL REHABILITATION CENTER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: KY 748-DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 748-DT) |
| 152WS0006X Optometrist, Sports Vision (Licence: KY 748-DT) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2012-12-28 |