| NPI | 1356987374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLYE S. SCOTT Owner 662-487-1316 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |