| NPI | 1578630794 |
|---|---|
| Doing Business As | VISION SOURCE TIFTON |
| Entity Type | Organization |
| Authorized Contact | TED A MCELROY President 229-382-4765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA GA1397) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2012-09-21 |