| NPI | 1932372158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER L TRAPHEAGEN Owner/President 239-573-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC3636) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL OPC3636) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2020-05-26 |