| NPI | 1922333111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN PETERSON Optometrist 775-782-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2022-07-21 |