| NPI | 1346381787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL E PAVLACKY President 701-346-3073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2009-07-28 |