| NPI | 1669711651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNA LEIGH HEADLEY BLACKERBY O PT Ometrist/Owner 205-337-8715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL SC58TA896) |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2013-02-11 |