| NPI | 1487880100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA H MONTECALVO Partner 937-320-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: OH 4167) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2009-06-09 |