NPI | 1477608610 |
---|---|
Doing Business As | BRIDGEPORT VISION SOURCE |
Entity Type | Organization |
Authorized Contact | TAMARA FRANKLIN Corporation Secretary 308-262-1252 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Enumeration Date | 2007-01-25 |
Last Update Date | 2008-04-11 |