NPI | 1518148287 |
---|---|
Entity Type | Organization |
Authorized Contact | SHERRIE EDMONDSON Manager, Licensing & Credentialing 629-999-5014 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-839-TA-366) |
Enumeration Date | 2007-11-21 |
Last Update Date | 2021-12-30 |