| NPI | 1700806916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALAN HENRY Vice President 508-837-3790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA OE007124T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OE007172T) |
| 152W00000X Optometrist (Licence: PA OEG001260) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-04-07 |