| NPI | 1154607943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELVIN GNANAKKAN Medical Director 602-770-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2021-04-14 |