| NPI | 1124259718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN SHIELDS Practice Administrator 410-279-2286 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD MD1738) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2009-12-30 |