| NPI | 1164805628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA GROSSHANS Manager/Sole Member 818-468-2809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3116) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: CO 3116) |
| 152WV0400X Optometrist, Vision Therapy (Licence: CO 3116) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |