| NPI | 1609868363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA M REYNOLDSON Optometrist 731-584-7942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN OD0000002255) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2020-08-27 |