| NPI | 1639163967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS ROBERT SCHRAGE President 574-271-7228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003372A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003372B) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2007-10-18 |