| NPI | 1720153059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD THOMAS TABELING Member LLC 859-342-5357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1246DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 4326) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |