| NPI | 1154410579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER REBECCA WALKER Sole Member/Owner 865-988-9787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 2236) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |