| NPI | 1720261720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS JAMES WILSON Doctor Owner 317-477-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002895AB) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2012-07-19 |