| NPI | 1043691595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J ROBERTSON Owner 252-443-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2021-10-15 |