NPI | 1689610305 |
---|---|
Entity Type | Organization |
Authorized Contact | TOM L MORTON Partner/Od 574-287-0890 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002590) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18002128) |
152W00000X Optometrist (Licence: IN 18001874) | |
Enumeration Date | 2006-06-21 |
Last Update Date | 2020-08-22 |