| NPI | 1669486528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY E CHRONISTER Administrator 870-935-6396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR MC-1284) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AR MC-1284) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2015-09-02 |