| NPI | 1477099877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHUNG MINH HO President 386-334-2705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 4991) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL 5234) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |