| NPI | 1104572494 |
|---|---|
| Former Legal Business Name | TIDE EYES LLC |
| Entity Type | Organization |
| Authorized Contact | ERICA JURAS Owner 443-223-3447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2023-05-02 |