| NPI | 1902071392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LEE FILLMORE President 509-484-5710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: WA MD00049255) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2019-04-10 |