| NPI | 1073831822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY GREGG WATSKY O PT Ometrist 810-220-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |