| NPI | 1215135066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE W MADSEN Owner 541-971-1514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 1670ATI) |
| 152W00000X Optometrist | |
| 207W00000X Ophthalmology (Licence: OR MD25517) | |
| 207W00000X Ophthalmology (Licence: OR DO22937) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2023-02-11 |