| NPI | 1760193601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN B WACHTER Owner 727-541-4469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-13 |