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 |