| NPI | 1275116832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB DUFOUR President 479-685-6875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics |
| 152WV0400X Optometrist, Vision Therapy | |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-05-03 |