| NPI | 1558657619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOREEN BROCK CFO 479-442-8653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2019-09-10 |