| NPI | 1821081621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN A. WHITELEATHER President/Owner 260-486-6106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003140A) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: IN 18003140A) |
| 152WL0500X Optometrist Low Vision Rehabilitation (Licence: IN 18003140A) | |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2008-08-13 |