| NPI | 1639204720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL E LANTER Preseident 317-844-6269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 0111609909) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Licence: IN 0111609909) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2012-04-18 |