| NPI | 1184773608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE R BULLOCK Optician 910-483-0548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: NC 454) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2008-02-08 |