| NPI | 1740495225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MARK CUSHING O PT Ometrist Owner 209-537-2359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 4418T) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2010-09-10 |