| NPI | 1063872505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA ELLEN LAWRENCE Optometrist 870-273-2581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2667) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2017-10-04 |