| NPI | 1700070083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILDA EDEAN LONG Optometrist/ Owner 540-875-8036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001106) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: VA 0618001106) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2019-08-02 |