| NPI | 1780907782 |
|---|---|
| Doing Business As | GENTILLY VISION SOURCE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL KLEAMENAKIS Owner 504-288-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: LA 1030-060T) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2018-12-12 |