| NPI | 1841409505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L FOGT Optometrist Sole Proprietor 772-287-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC980) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2008-03-07 |