| NPI | 1659318541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE JEAN FISKE Co Owner 970-241-9299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2008-01-26 |