| NPI | 1336438191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MARLYN DAMLO Optometrist/President 952-229-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2476) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2011-04-01 |