| NPI | 1326503699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA W JOLLY Director Of Operations 800-500-4667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist |
| Additional Taxonomies | 152W00000X Optometrist |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2023-01-24 |