| NPI | 1659731560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELIA RITTER Credentialing Coordinator 502-244-2441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1922) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |