| NPI | 1659538171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY K CARROLL Office Manger 865-588-1886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN ODT-896) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: TN 0896) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2019-07-11 |