| NPI | 1114268794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON A FALDEN Physician 904-418-8339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |