| NPI | 1124021084 |
|---|---|
| Doing Business As | SOUTHWIND EYECARE |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN LANE WHITTREDGE Secretary/Treasurer 620-662-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-03-02 |