| NPI | 1558612788 |
|---|---|
| Doing Business As | VISION SOURCE OF GVR |
| Entity Type | Organization |
| Authorized Contact | MARK F WAHLMEIER President 785-443-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2677) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-09-27 |