| NPI | 1457562266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA FLY Owner Licensed Optician 901-362-1496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TN 482) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |