NPI | 1407984396 |
---|---|
Former Legal Business Name | MAHAN - RIDLEY PLLC |
Entity Type | Organization |
Authorized Contact | BEN BOB MAHAN Owner 931-393-6004 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN TN MD18870) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TN TN-OD-T394) |
207W00000X Ophthalmology (Licence: TN TN MD 9867) | |
Enumeration Date | 2007-03-01 |
Last Update Date | 2017-08-22 |