| NPI | 1649440116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE HOSKINS President 574-276-0226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002697) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 18002697) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2022-07-21 |