| NPI | 1477856474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA RAE ZELLER MANLEY Director 301-951-0320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist Vision Therapy (Licence: MD TA 1930) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: MD TA 1930) |
| 152WS0006X Optometrist Sports Vision | |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2024-02-07 |