| NPI | 1568988814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVEN MATTHEW LAMBART Vice President 269-240-4464 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004625) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2017-08-18 |