| NPI | 1487840401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL R. MINTON Optometrist 731-686-1647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 1009) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 1928) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2012-06-18 |