| NPI | 1770972515 |
|---|---|
| Doing Business As | ABC VISION SOURCE HILLSDALE |
| Entity Type | Organization |
| Authorized Contact | MARI WARD President 503-473-8039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3023ATI) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 2151ATI) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-01-16 |