| NPI | 1851417117 |
|---|---|
| Doing Business As | VISION SOURCE MIDWEST CITY |
| Entity Type | Organization |
| Authorized Contact | RUSSELL LAVERTY Optometrist 405-732-2277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OK 818) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |