| NPI | 1679643100 |
|---|---|
| Doing Business As | LATHAM OPTICAL |
| Entity Type | Organization |
| Authorized Contact | VIRGINIA DOMAIN CFO 952-476-4185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 2439) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2013-04-08 |