| NPI | 1194033126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER CHARLES FUSCO Owner/President 757-424-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VA 0618000205) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618000205) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2010-11-03 |