| NPI | 1073788923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH BLACK President/Owner 704-847-9833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1176) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NC 1176) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2010-02-21 |