NPI | 1275025207 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM V PADULA Owner 203-453-0617 |
Organization Subpart ? | No |
Primary Taxonomy | 152WS0006X Optometrist, Sports Vision (Licence: CT 000858) |
Enumeration Date | 2018-06-05 |
Last Update Date | 2018-06-05 |