NPI | 1154596948 |
---|---|
Entity Type | Organization |
Authorized Contact | LAWRENCE P FULLER Optometrist Sole Provider 407-846-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC797) |
Enumeration Date | 2008-04-23 |
Last Update Date | 2008-04-23 |