| NPI | 1063896777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GOVE Asst. Practice Administrator 704-774-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |