| NPI | 1518151059 |
|---|---|
| Doing Business As | EYEDEAL OPTICAL TUPELO |
| Entity Type | Organization |
| Authorized Contact | REAGAN LEE FORD Owner 662-332-3325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 775) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-12-17 |