| NPI | 1710012877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES K BROWN Doctor 205-967-2103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: AL S462TA018) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: AL SB75TA798) |
| 152W00000X Optometrist (Licence: AL S462TA018) | |
| 152W00000X Optometrist (Licence: AL SB75TA798) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2019-06-21 |