| NPI | 1245417062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNETTE KEISER Optometrist/President 814-942-7184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: PA OE000873) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG000783) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2010-04-20 |