| NPI | 1811174550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELLISA M FELLINES Practice Administrator 541-548-2488 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 2823ATI) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2022-07-21 |