| NPI | 1710420856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BUCK Sole Proprietor/Sole Manager 757-814-0827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002155) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2017-01-08 |