| NPI | 1255316006 |
|---|---|
| Doing Business As | VISION SOURCE MICHAEL D. BLACKBURN, O.D. |
| Entity Type | Organization |
| Authorized Contact | MICHAEL D BLACKBURN President Owner 205-980-5152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S672TA330) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2012-02-21 |