| NPI | 1114111044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY A RILEY Owner 918-341-3284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 966) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 965) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |