| NPI | 1336212117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A BUCK President 219-464-8223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2024-11-20 |