| NPI | 1689789562 |
|---|---|
| Former Legal Business Name | VITREO-RETINAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | CHARLES E LYON President 318-222-8421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |