| NPI | 1023433067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNIE SHANNON COX Administrator 615-773-7535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management |
| Additional Taxonomies | 152W00000X Optometrist |
| 152WS0006X Optometrist, Sports Vision | |
| 152WX0102X Optometrist, Occupational Vision | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-05-30 |