| NPI | 1417288671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMAN LYLE LASTINGER Owner/Doctor 478-475-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: GA OPT001094) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2010-01-27 |