| NPI | 1396408720 |
|---|---|
| Doing Business As | LAKESIDE FAMILY VISION |
| Entity Type | Organization |
| Authorized Contact | KELLY J MCLAIN Optometrist/Owner 308-928-2187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2022-06-16 |