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 |