| NPI | 1922103209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY BUTTS Assistant Director 419-720-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation |
| 152WX0102X Optometrist Occupational Vision | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2013-04-23 |