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 |