| NPI | 1487664546 |
|---|---|
| Other Name | OPTICAL |
| Entity Type | Organization |
| Authorized Contact | MARK W ULRICKSON Owner Partner 906-225-4512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2014-02-25 |