| NPI | 1548789951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA CARSON WOOLWINE O PT Ometrist 813-270-5929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 5248) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |