| NPI | 1932521580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJENDER MACHA President/Owner 765-649-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002944A) |
| Additional Taxonomies | 152WS0006X Optometrist Sports Vision (Licence: IN 18002944A) |
| 152WV0400X Optometrist Vision Therapy (Licence: IN 18002944A) | |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2014-01-22 |