NPI | 1003055872 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK H ALLEN Owner/Optometrist 601-939-6366 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MS 621) |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MS 621) |
Enumeration Date | 2009-02-18 |
Last Update Date | 2014-07-03 |