| NPI | 1932502507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ZACHMAN Owner 260-432-1231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: IN 351655933) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2022-04-20 |