| NPI | 1700049533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A GILLES Optometrist 812-853-8191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: IN 18002239) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |