| NPI | 1245505825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BULLIN Owner 601-212-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MS 783) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |