| NPI | 1811022916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK W BOWLES Administrator 317-844-6269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001891) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003126) |
| 152W00000X Optometrist (Licence: IN 18001602) | |
| 152W00000X Optometrist (Licence: IN 18003205) | |
| 152W00000X Optometrist (Licence: IN 18002572) | |
| 207W00000X Ophthalmology (Licence: IN 01033785) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-10-03 |