| NPI | 1447232913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN L VOSS Medicare/Credentialing Specialist 609-587-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2012-09-18 |