NPI | 1568657526 |
---|---|
Entity Type | Organization |
Authorized Contact | REED H JARVIS Owner 270-759-1429 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1707DT) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 1707DT) |
Enumeration Date | 2007-09-12 |
Last Update Date | 2021-12-21 |