| NPI | 1750577490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY L LARSON Owner 407-333-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 3069) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 3015) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2020-04-13 |