| NPI | 1376722249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT GASKIN Practice Manager 804-285-7533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic (Licence: VA 0101035231) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |