| NPI | 1659564706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DAVID JACO O PT Ometrist 270-753-2842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1292DT) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1768DT) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2011-03-10 |