| NPI | 1194974782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC JAY GANNON Director 954-776-5223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: FL OPC1271) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2009-08-04 |