| NPI | 1073458949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANIKA GOODWIN Manager 336-705-0516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2026-04-20 |
| Last Update Date | 2026-07-28 |