| NPI | 1275168528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED G SMEDLEY Authorized Official 928-775-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 152W00000X Optometrist |
| 156F00000X Technician/Technologist | |
| 156FX1100X Technician/Technologist, Ophthalmic | |
| 156FX1202X Technician/Technologist, Optometric Technician | |
| 207W00000X Ophthalmology | |
| 261QS0132X Clinic/Center, Ophthalmologic Surgery | |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2024-04-19 |