| NPI | 1558423962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL LEIGH DUCKETT Credentialing & Insurance Coordinat 901-357-0371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 1797) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2010-10-04 |