| NPI | 1245228204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY WOODS Billing Manager 270-765-6066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2016-06-13 |