| NPI | 1124238050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D E Member 757-635-2625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1201X Technician/Technologist, Optometric Assistant |
| Additional Taxonomies | 152W00000X Optometrist |
| 156FX1101X Technician/Technologist, Ophthalmic Assistant | |
| 156FX1202X Technician/Technologist, Optometric Technician | |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-09-11 |