NPI | 1477526747 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENT L WILDE President 952-567-6143 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
332H00000X Eyewear Supplier (Equipment, not the service) | |
291U00000X Clinical Medical Laboratory | |
Enumeration Date | 2006-02-08 |
Last Update Date | 2017-02-22 |