| NPI | 1588208144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JENSEN CEO 605-371-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |