| NPI | 1619366507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH FAULK President 704-394-3886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2328) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2255) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |