| NPI | 1902000904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY C CAMPBELL Optometrist Owner 580-762-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK OK2144) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK OK2144) |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OK OK2144) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2016-12-30 |