| NPI | 1801171582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALBERT BREEDEN O PT Ometrist 541-840-3168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 3410ATI) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2011-10-13 |