| NPI | 1821159435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA BUTSON Accounts Manager 507-345-5087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2021-09-24 |