| NPI | 1770099327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY L STEVENS Director Of Revenue Assurance 502-244-2441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: PA 007663) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2025-03-11 |