| NPI | 1710150347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE G. POWELL Owner 419-698-4949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2016-09-29 |