| NPI | 1740068592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN CANTRELL Manager Of Health Services 561-208-8464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-09-21 |