| NPI | 1790972388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS FRANCES DETERMAN Doctor Of O PT Ometry 928-782-7557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 786) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 663) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2021-07-26 |