| NPI | 1992032205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY RAY CLINES O PT Ometrist 219-531-1624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002436) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2009-11-06 |