| NPI | 1558724492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID GREENWOOD Owner 701-566-5390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-05-21 |