| NPI | 1316012099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN G ANDERSON Owner 731-364-2150 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN ODT241) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2021-06-21 |