| NPI | 1548332794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESE COCHRAN Practice Administrator 317-839-2368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 56000039) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2019-07-22 |