| NPI | 1407825037 |
|---|---|
| Other Name | TUPELO VISION CENTER |
| Entity Type | Organization |
| Authorized Contact | MIKE L MCCULLOUGH Office Manager 662-243-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 487) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MS TPA 94061) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-11-13 |