NPI | 1104861707 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRIS JAY AUGUSTIAN Chief Executive Officer 920-405-5382 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2006-06-18 |
Last Update Date | 2022-03-31 |