| NPI | 1144499013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA K GILES Accounts Manager 765-362-2706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002838a) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18002838A) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: IN 18002838A) | |
| 152WP0200X Optometrist, Pediatrics (Licence: IN 18002838A) | |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2008-02-26 |