| NPI | 1992014526 |
|---|---|
| Doing Business As | TRI STATE OPTICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | VICKI C LATOURETTE Executrix Of Alan Latourette Estate 479-636-2012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2011-03-29 |