| NPI | 1881725737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON L. BRADLEY President/CEO 701-852-5626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 544) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2016-10-07 |