| NPI | 1316113616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C. CHRIS COLLINS President 601-638-2081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 522) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MS 522) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2011-11-17 |