| NPI | 1407949753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WESLEY SIVESIND Optometrist 605-334-7737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: SD 610) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2020-08-22 |