| NPI | 1992802920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ALAN GASS Administrator 605-665-9638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SD 0017) |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-08-02 |