| NPI | 1598649691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUITTA R GREEN Chief Financial Officer 662-624-4292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-01 |