| NPI | 1326389818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE M WILEY Optometrist 787-637-0834 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PR 464) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: PR 464) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |