NPI | 1174635700 |
---|---|
Entity Type | Organization |
Authorized Contact | GLEN H. STONE Owner/ Doctor 662-563-9880 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MS 736) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MS 535) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2008-05-06 |