| NPI | 1568646107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W THOMAS GREEN President 740-439-1098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3120/T800) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4641/T1416) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2013-01-10 |