| NPI | 1235301896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD PRATT Office Manager 602-547-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WS0006X Optometrist, Sports Vision |
| 152WV0400X Optometrist, Vision Therapy | |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-03-24 |