| NPI | 1538666235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON HAWKLEY MITCHELL Member 802-730-5167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: VT 030.0068209) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |