| NPI | 1982756789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LOU FREY VP Operations 715-392-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2021-08-05 |