| NPI | 1932861713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY REIDHAAR O PT Ometrist 260-471-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| 152WP0200X Optometrist Pediatrics | |
| 332H00000X Eyewear Supplier | |
| Enumeration Date | 2021-10-09 |
| Last Update Date | 2021-11-23 |