| NPI | 1760651046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY D ROGERS Owner 731-925-4902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2008-03-07 |