| NPI | 1942499660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L ROBERTS Owner 918-647-3284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 781) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: OK 781) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2011-07-29 |