| NPI | 1770757791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ALAN KYLE CEO 906-228-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901003683) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MI 4901003683) |
| 152WP0200X Optometrist, Pediatrics (Licence: MI 4901003683) | |
| 152WS0006X Optometrist, Sports Vision (Licence: MI 4901003683) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-05-28 |