| NPI | 1487833513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS COLO Office Manager 860-668-0266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2008-04-28 |