| NPI | 1447766936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FRICKE Assistant Secretary 844-377-6468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2017-12-19 |