| NPI | 1982106548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLEE LIZABETH DOUGHERTY President 800-824-2492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 229N00000X Anaplastologist |
| Additional Taxonomies | 156FX1700X Technician/Technologist, Ocularist |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2020-05-06 |