NPI | 1366626616 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER R BAILEY Doctor/Owner 765-529-9364 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002774B) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18002774B) |
152WP0200X Optometrist, Pediatrics (Licence: IN 18002774B) | |
152WV0400X Optometrist, Vision Therapy (Licence: IN 18002774B) | |
Enumeration Date | 2007-12-21 |
Last Update Date | 2007-12-21 |