| NPI | 1770534489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE ALEXIS COFFMAN President 480-575-7518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 3881) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-09-30 |