| NPI | 1104206994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HUNTER NEWSOM President 863-385-1544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-01-05 |