NPI | 1083908487 |
---|---|
Entity Type | Organization |
Authorized Contact | REBECCA WINCEK BATESON President 723-349-8000 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG001265) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: PA OEG001265) |
152WP0200X Optometrist, Pediatrics (Licence: PA OEG001265) | |
Enumeration Date | 2011-06-02 |
Last Update Date | 2011-06-02 |