| NPI | 1104237601 |
|---|---|
| Doing Business As | FAMILY VISION CLINIC |
| Entity Type | Organization |
| Authorized Contact | JACOB G DESPAIN Optometrist 307-587-2404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WY 327T) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2014-05-19 |