NPI | 1275800559 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM RAY LOSIE President 541-686-1117 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: OR 1709ATI) |
Additional Taxonomies | 152WX0102X Optometrist, Occupational Vision (Licence: OR 1709ATI) |
332H00000X Eyewear Supplier (Equipment, not the service) | |
152WS0006X Optometrist, Sports Vision (Licence: OR 1709ATI) | |
152WV0400X Optometrist, Vision Therapy (Licence: OR 1709ATI) | |
152WC0802X Optometrist, Corneal and Contact Management (Licence: OR 1709ATI) | |
152WL0500X Optometrist, Low Vision Rehabilitation (Licence: OR 1709ATI) | |
152WP0200X Optometrist, Pediatrics (Licence: OR 1709ATI) | |
Enumeration Date | 2011-11-30 |
Last Update Date | 2020-04-06 |