| NPI | 1578613295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R ALAN ROUSH President 260-347-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 0921390001) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2016-07-22 |