| NPI | 1295100204 |
|---|---|
| Doing Business As | ACTIVE EYECARE OF SURPRISE |
| Entity Type | Organization |
| Authorized Contact | MARK EDWARD FECHTEL Owner 623-214-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ 1117) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2015-12-02 |