| NPI | 1407033764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GYSBERTUS JOHANN METTEN Ownder 804-272-1987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 1101000600) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |