| NPI | 1447708268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ANDERSON President 406-587-8333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT OPT-OPT-LIC-2799) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP-100378) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2017-02-23 |