| NPI | 1245239037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER D. LATHAM Office Manager 270-926-3297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207W00000X Ophthalmology |
| 152W00000X Optometrist | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2022-07-21 |