| NPI | 1902246291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ROBERT HOLT O PT Ometrist/Owner 623-824-2591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1305) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: AZ 1305) |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: AZ 1305) | |
| 152WS0006X Optometrist Sports Vision (Licence: AZ 1305) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2013-10-10 |