| NPI | 1851580351 |
|---|---|
| Doing Business As | LAKE WORTH VISION SOURCE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL D CONTE Owner 817-626-4441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 3120T) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2012-02-02 |