| NPI | 1801275193 |
|---|---|
| Doing Business As | WOW VISION THERAPY |
| Entity Type | Organization |
| Authorized Contact | DAN L FORTENBACHER Owner 269-983-3309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901002693) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901004791) |
| 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901004454) | |
| 152W00000X Optometrist (Licence: MI 4901002693) | |
| 152WS0006X Optometrist, Sports Vision (Licence: MI 4901002693) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-21 |