| NPI | 1437143849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOMER ANDREW WARD Optometrist 270-683-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2009-07-07 |