| NPI | 1184417750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP L BERTUCCI Owner 228-380-4441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-05-27 |