| NPI | 1932629755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MARIE KELLER Owner/O PT Ometrist 701-390-1315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ND 710) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |