| NPI | 1033493275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS VICTOR WEATHERHOLT Owner Of Corporation 434-385-5318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000350) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-12-06 |