| NPI | 1194020800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN MEADOWS TYSON Optometrist 256-225-1689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-C04-TA-823) |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2019-04-10 |