| NPI | 1609502178 |
|---|---|
| Other Name | ST JOHNS EYE ASSOCIATES AT SAN MARCO |
| Entity Type | Organization |
| Authorized Contact | DONNA MARIE BACKS Credentialing 805-433-2901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-07-27 |