| NPI | 1235401514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA JOHNSON-WYATT Owner/Optometrist 731-660-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2019-09-25 |