| NPI | 1265945653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PELLER President 480-961-1865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |