| NPI | 1710028618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BLACKSTON Office Manager 334-222-6325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-950-TA-529) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2024-08-26 |