| NPI | 1497948541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WACHTER Owner 636-200-4393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1073DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1469DT) |
| 152W00000X Optometrist (Licence: KY 1767DT) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2019-07-08 |