| NPI | 1487925491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L GIBSON Optometrist/Owner 270-625-0380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1780DT) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2024-05-06 |