| NPI | 1568631406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON NATHANIEL HICKS Optometrist 614-253-5593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OH 2946) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2011-12-12 |