| NPI | 1205034808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAX ALAN HENRY Owner 812-372-4463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003452A) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2013-08-05 |