| NPI | 1649408774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MARTIN Vice President 765-653-8245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003118A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001975A) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18003118A) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18001975A) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2015-06-08 |