| NPI | 1821001389 |
|---|---|
| Former Name | LORI ANN MASTALANSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MI 4901004066) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2021-04-01 |