| NPI | 1477735538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE LESLIE WIRES President 419-422-2015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3756t705) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 3756t705) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2020-01-24 |