| NPI | 1770127342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY JON KINTNER Owner 574-255-1231 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| 152WP0200X Optometrist, Pediatrics | |
| 152WS0006X Optometrist, Sports Vision | |
| 152WV0400X Optometrist, Vision Therapy | |
| 152WX0102X Optometrist, Occupational Vision | |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2020-03-03 |