NPI | 1174705438 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL WAYNE STONER Owner/ Doctor 541-367-2188 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2480ATI) |
Additional Taxonomies | 332H00000X Eyewear Supplier (Licence: OR 2480ATI) |
Enumeration Date | 2007-11-28 |
Last Update Date | 2010-08-02 |