| NPI | 1447495379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA NICOLE WITTROCK Managing Member Plc 515-360-5636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 002409) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 02204) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2014-03-06 |