| NPI | 1073784351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD B LEACH President/Doctor 505-865-4812 |
| Organization Subpart ? | |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM 245/OP2245) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NM 245/OP2245) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2012-10-09 |