| NPI | 1164523767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA COLBY-AXE Owner 740-773-4950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 5627) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 3392) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |