| NPI | 1912194234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEMMA MARIA THERESIA RUSOFF Visual Trainer 952-270-8032 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |