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Eye and Vision Services Providers Optometrist

Provider NPI: 1568922573

Organization Information:
Organization is not Subpart
Authorized Official:  MATTHEW KEENAN BARNETT  OWNER  605-348-2323

Practice Location:
Tel: 605-348-2323  Fax: 605-348-6694

Business Mailing Address:
Tel: 605-348-2323  Fax: 605-348-6694

NPI Information:
NPI: 1568922573
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 152W00000X





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