| NPI | 1669748711 |
|---|---|
| Doing Business As | IBERVILLE OPTICS |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MICHAEL BRADLEY Owner/Manager 225-385-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |