| NPI | 1659864395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN LARSSON Optometrist/ Owner 209-526-9883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: CA 9225T) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |