| NPI | 1700440633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR WOODBURY BLADH President 909-861-3737 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| 152WP0200X Optometrist Pediatrics | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-06-11 |