| NPI | 1790738813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN HARRIS Administrator 330-722-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2012-10-09 |