| NPI | 1760635577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN POLONSKI Doctor 520-576-5110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2023-08-03 |