| NPI | 1154961134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA C SCOTT Owner 410-571-7998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |