| NPI | 1710707716 |
|---|---|
| Doing Business As | ACTIVE EYE CARE OF SURPRISE |
| Entity Type | Organization |
| Authorized Contact | INGA LILLIANA FORS Od/ Owner 623-214-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| 152WP0200X Optometrist, Pediatrics | |
| 152WV0400X Optometrist, Vision Therapy | |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-14 |