NPI | 1174756902 |
---|---|
Entity Type | Organization |
Authorized Contact | BYRON W. WRIGHT Owner 618-339-8951 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization |
Additional Taxonomies | 152W00000X Optometrist |
156FC0801X Technician/Technologist, Contact Lens Fitter | |
156FX1800X Technician/Technologist, Optician | |
305S00000X Point of Service | |
Enumeration Date | 2009-08-27 |
Last Update Date | 2019-08-26 |