| NPI | 1811726193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BOCARDO Practice Manager 509-505-7481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2024-08-02 |