| NPI | 1235329848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY E OWENS Clinical Director 904-389-9989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4045) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2008-06-25 |