| NPI | 1629545157 |
|---|---|
| Doing Business As | SOUTHSIDE FAMILY VISION |
| Entity Type | Organization |
| Authorized Contact | STUART DAWSON Owner 631-813-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |