| NPI | 1225364110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA RYAN President 480-899-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 850) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: AZ 850) |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2009-10-27 |