| NPI | 1306266291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK DAVID CZYWCZYNSKI Owner/Optometrist 701-516-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 681) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2023-03-07 |