| NPI | 1114321502 |
|---|---|
| Doing Business As | TYSON EYE AT BONITA EYE CENTER |
| Entity Type | Organization |
| Authorized Contact | FARRELL C TYSON Medical Director/ Owner 239-542-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |