| NPI | 1598045957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA R ZELLER MANLEY Owner 301-951-0320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: MD TA1930) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: MD TA1930) |
| 152WS0006X Optometrist, Sports Vision (Licence: MD TA1930) | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2024-02-07 |