| NPI | 1629487814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE K. ESCARAVAGE Member/Manager 910-444-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 200600645) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2018-10-15 |