| NPI | 1356524011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ALAN KENMORE President 405-799-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2366) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 2366) |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OK 2366) | |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2008-02-07 |