| NPI | 1114940160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA M GUERRERO Business Office Supervisor 620-275-4938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-03-12 |