NPI | 1902175540 |
---|---|
Entity Type | Organization |
Authorized Contact | EVA TAKACS Optometrist/Owner/President 520-241-9522 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ 1614) |
Enumeration Date | 2011-12-28 |
Last Update Date | 2011-12-28 |