| NPI | 1497168587 |
|---|---|
| Doing Business As | VISION SOURCE OWASSO |
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILLIAM GAYDOS Owner/Physician 918-510-6432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2137) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2015-01-12 |