| NPI | 1699154054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DABELOW Director Of Finance And Insurance 317-254-6480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003485) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2016-04-11 |