| NPI | 1538450200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINWARD LEE MACKEWIZ Owner/President 302-834-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DE I30001174) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |