NPI | 1730441601 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSEPH FRANK CERAVOLO President 706-323-8127 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL MD25848) |
Additional Taxonomies | 152W00000X Optometrist (Licence: AL S827TA355) |
Enumeration Date | 2012-06-15 |
Last Update Date | 2012-09-24 |