NPI | 1386979953 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW SCOTT PESTRUE O PT Ometrist 989-684-5526 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003830) |
Enumeration Date | 2009-10-14 |
Last Update Date | 2009-10-14 |