| NPI | 1619211240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA S DUKES Manager/Co Owner 541-552-0677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist Vision Therapy (Licence: OR 2413) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |