| NPI | 1235263799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY MOODY Office Mgr. 918-272-5311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-04-20 |