| NPI | 1417435470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH LYNN STOKES Owner 904-945-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL 215117) | |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-21 |