| NPI | 1205111036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK B CRAFFORD Office Manager 757-671-8957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| 152WP0200X Optometrist, Pediatrics | |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2012-04-18 |