| NPI | 1396905170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOYLE D. HOLLE President/O PT Ometrist 480-345-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 714) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: AZ 714) |
| 152WP0200X Optometrist Pediatrics (Licence: AZ 714) | |
| 152WS0006X Optometrist Sports Vision (Licence: AZ 714) | |
| 152WX0102X Optometrist Occupational Vision (Licence: AZ 714) | |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2008-06-14 |