| NPI | 1538482906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER WEBSTER Administrator 270-415-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY KY 29828) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2021-11-11 |