| NPI | 1740548767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD S GRIMSHAW Owner/O PT Ometrist 904-751-4483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2015-11-24 |