| NPI | 1134252711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMIE LEE BLAN O PT Ician Owner 402-451-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2008-06-11 |