| NPI | 1841529690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A MARSH Business Owner 3366-587-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 0700) |
| Additional Taxonomies | 156F00000X Technician/Technologist (Licence: TN 0700) |
| 156FC0800X Technician/Technologist Contact Lens (Licence: TN 0700) | |
| 156FC0801X Technician/Technologist Contact Lens Fitter (Licence: TN 0700) | |
| 156FX1202X Technician/Technologist Optometric Technician (Licence: TN 0700) | |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2009-12-08 |