| NPI | 1023156924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP L. MATTSON President 256-882-1024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: AL S-A71-TA-632) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-A71-TA-632) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2025-09-11 |