| NPI | 1295054351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDE T. WAGGONER President/Optometrist 505-323-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM 547) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2012-06-26 |