| NPI | 1689221970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK BERGVIN COO 931-456-2728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-10-21 |