| NPI | 1659645380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS JAY AUGUSTIAN Chief Executive Officer 920-405-5382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2022-04-20 |