| NPI | 1679641203 |
|---|---|
| Doing Business As | WILD IRIS OPTOMETRIC GROUP |
| Entity Type | Organization |
| Authorized Contact | LAURIE RUTH CHAIKIN O PT Ometrist Owner 510-538-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 10195) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: CA 7597) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2008-07-22 |