| NPI | 1306900790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK NORDIN Owner President 606-788-0433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1176DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 11243DT) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2014-12-26 |