| NPI | 1457661258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE NICOLE LONG Office Manager 757-766-1988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001095) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-14 |