| NPI | 1003010323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE M ROSSER O PT Ician Owner 757-220-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: VA 1101000404) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: VA 1101000404) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2008-03-17 |