| NPI | 1467006254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRMA SALAZAR Director 928-502-0145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-31 |