| NPI | 1124085618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK H STINES Owner 308-384-6922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2008-04-20 |