| NPI | 1619150976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA A HALLER Owner 740-774-4616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 4841) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 4841) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2018-06-21 |