| NPI | 1497724256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WHITE Chief Executive Officer 251-432-4117 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2022-08-30 |