| NPI | 1003547969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY DESHUN AVERY Owner/ Licensed Dispensing Optician 901-461-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-22 |