| NPI | 1346273901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL D VANDIVER Office Manager 812-476-4936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002713B) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2008-03-17 |