| NPI | 1609045202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY S TAVEL President 317-924-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001649A) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2021-10-27 |