| NPI | 1891850707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER L JORDAN President 307-682-2020 |
| Organization Subpart ? | |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: WY 142-T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WY 93-T) |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: WY 288-T) | |
| 152WV0400X Optometrist Vision Therapy (Licence: WY 263-T) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2010-04-13 |