| NPI | 1225253149 |
|---|---|
| Former Legal Business Name | MIKE BOECKMAN, O.D., PC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE BOECKMAN President 405-756-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK ok 1041) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2016-05-02 |