| NPI | 1154716421 |
|---|---|
| Doing Business As | JEFFERSON VILLAGE EYE CARE |
| Entity Type | Organization |
| Authorized Contact | ROGER G DAVIS President 336-909-0061 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |