| NPI | 1568932994 |
|---|---|
| Doing Business As | WOW VISION THERAPY |
| Entity Type | Organization |
| Authorized Contact | CHARLES IAN FORTENBACHER CFO 616-447-1444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy |
| Additional Taxonomies | 152WS0006X Optometrist, Sports Vision |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2018-11-28 |