| NPI | 1437682374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BANKS DANIEL Sole Member 334-398-3384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-827-TA-355) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |