| NPI | 1619923745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK C CADDELL Manger 205-943-4604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-03-18 |