| NPI | 1619926359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN M. DICKERSON President/O PT Ometrist 931-381-4911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN ODT612) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2010-12-17 |