| NPI | 1225228737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA WILSON Insurance Specialist 540-722-0445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000300) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2010-11-24 |