| NPI | 1720012701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE S STUFFLESTREET Compliance Officer 423-722-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: TN 0000000145) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2023-10-31 |