NPI | 1134316086 |
---|---|
Other Name | MALINDA LUCKY FLORES, OD |
Entity Type | Organization |
Authorized Contact | MALINDA LUCKY FLORES Owner 304-375-4748 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: WV 951-OD) |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: WV WV 951-OD) |
Enumeration Date | 2007-09-25 |
Last Update Date | 2008-05-16 |