| NPI | 1932383627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ROBERT BUNDY President 406-549-9413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 564) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MT 564) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2023-12-26 |