| NPI | 1336219922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDA L BOMAN Ins Supervisor 812-258-4510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2013-04-26 |