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 |