| NPI | 1720254626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIOFER REED WILKERSON Insurance Clerk 615-381-8435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN TN2007) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |