| NPI | 1992870604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARAN M DECALESTA President 541-343-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2022-06-28 |