NPI | 1992271480 |
---|---|
Doing Business As | EYES ON BROAD |
Entity Type | Organization |
Authorized Contact | BENJAMIN DEAN COLSTON Optometrist/Owner 817-301-5745 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Enumeration Date | 2018-10-23 |
Last Update Date | 2018-10-23 |