| NPI | 1912297417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A RASMUDDEN Optometrist 505-983-7746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NM 371) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2011-04-18 |