| NPI | 1043563935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN BLAICHER Manager/O PT Ician 901-373-4207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN TN611) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |