| NPI | 1104150333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY SLAGLE Administrator 402-552-2806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2014-01-30 |