| NPI | 1265807382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE ONIEL DURRANT O PT Ometrist 614-493-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 60189678) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |