| NPI | 1174294870 |
|---|---|
| Doing Business As | PUYALLUP VISION SOURCE PS |
| Doing Business As | PUYALLUP VISION SOURCE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID NOBLE Doctor/Owner 253-472-1188 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2023-10-09 |