| NPI | 1285736355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LAYNE NELSON Owner 580-623-5073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 1011) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OK 1011) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2014-02-11 |