| NPI | 1649449745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S. HARRIS Owner/Doctor 574-893-7050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: IN 1800192A) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IN 18001927A) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2011-01-28 |