NPI | 1164709218 |
---|---|
Doing Business As | FREMONT VISION SOURCE |
Entity Type | Organization |
Authorized Contact | AMY JENNIFER DEVRIES Owner/Optometrist 402-721-8032 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1358) |
Enumeration Date | 2011-11-03 |
Last Update Date | 2020-12-11 |