| NPI | 1124347513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J HAWK Optometrist / Owner 816-308-9132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MO 2004004593) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2022-03-11 |