| NPI | 1770996407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY SANDERS Audiologist 662-510-2138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-06-10 |