| NPI | 1144556655 |
|---|---|
| Doing Business As | CUSTOM EYES |
| Entity Type | Organization |
| Authorized Contact | JOANNA M GERVAIS Optometrist/Owner 541-777-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3263AT) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-11-16 |