| NPI | 1407025968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L. HOLSCLAW-JONES O PT Ometrist 423-543-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: TN ODT0000001180) |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2022-11-09 |