| NPI | 1588622278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES VERSACKAS President 515-243-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-08-22 |