| NPI | 1477587939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEIF ERICKSON Optometrist 802-775-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VT 0300000275) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2009-03-25 |