NPI | 1578606810 |
---|---|
Entity Type | Organization |
Authorized Contact | JODY R LAPORTE President 262-752-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 26907-020) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 44898-020) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2009-02-19 |