| NPI | 1487051066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIS S MUNCEY Owner 505-899-8993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM 2427) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NM 640) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2017-12-07 |