| NPI | 1619395894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGHA MISHELLE NIELSEN Owner/Doctor 210-590-2485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist Vision Therapy (Licence: TX 7776) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-04-03 |