NPI | 1902985682 |
---|---|
Former Legal Business Name | VISION EXPRESS |
Entity Type | Organization |
Authorized Contact | BRUCE R WALLACE Optometrist/Owner 253-941-0071 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: WA 602 513 684) |
Enumeration Date | 2006-11-03 |
Last Update Date | 2020-08-22 |