| NPI | 1124204797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID WATTS President 812-275-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001713A) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-05-01 |