NPI | 1558884767 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY S DAVIS Owner/Board Certified Ocularist 608-630-9200 |
Organization Subpart ? | No |
Primary Taxonomy | 156FX1700X Technician/Technologist Ocularist (Licence: WI 14366-20) |
Enumeration Date | 2017-07-19 |
Last Update Date | 2022-07-21 |