| NPI | 1306928064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN C MANNIX President Owner 219-362-6297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2025-09-11 |