| NPI | 1790962348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY L OLSEN Owner 405-341-2062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 881) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OK 881) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2009-07-09 |